Nicki A Dowling

Deakin University · School of Psychology

This systematic review aimed to determine whether the use of specific behaviour change technique (BCT) groups are associated with greater effectiveness for psychosocial interventions delivered to family and close friends (FCFs) impacted by addiction. A systematic search of peer-reviewed and grey literature published until August 2021 identified 32...

Background and aims: It is well understood that engagement with some forms of gambling, like EGMs, is riskier than other forms. However, while reports of associations are common, few studies have attempted to evaluate and compare the relative risk of all available forms, and none have estimated the relative contribution of each form to the total b...

Gambling help websites are an important source of information for gamblers and affected others, but they contain large amounts of information, making it difficult to navigate and access required resources. Usability of such websites can be improved through the implementation of chatbots, which are programmed to respond to user requests in natural l...

Background: Pharmacological interventions for disordered and problem gambling have been employed in clinical practice. Despite the availability of several reviews of the efficacy of pharmacological interventions for disordered or problem gambling, few have employed systematic search strategies or compared different categories of pharmacological in...

Background Over the last decade, the provision of online gambling has intensified with increased access, enhanced betting markets, a broader product range, and prolific marketing. However, little research has explored how this intensification is influencing contemporary gambling experiences. This study focused on two research questions: 1) What cha...

Background and aims: Gambling-related harm to concerned significant others (CSOs) is an important public health issue since it reduces CSOs' health and wellbeing in numerous life domains. This study aimed to 1) estimate the first national prevalence of CSOs harmed by gambling in Australia; 2) identify the characteristics of CSOs most at risk of ha...

An emerging literature has identified optimal low-risk gambling limits in an effort to reduce gambling-related harm. Concerns have, however, been raised about the construction of aggregate low-risk limits that are applied to all gambling activities and there is support from gambling experts and the general public in Australia for the identification...

Background and aims: Multiple studies have examined barriers and facilitators to help-seeking, but the prevalence of help-seeking for problem gambling (PG) is not well established. We aimed to estimate the international prevalence of help-seeking for PG among the general population and among subgroups of people at risk for PG (i.e. low-risk, moder...

Background: The presence of discrete but fluctuating precipitants, in combination with the dynamic nature of gambling episodes, calls for the development of tailored interventions delivered in real time, such as just-in-time adaptive interventions (JITAIs). JITAIs leverage mobile and wireless technologies to address dynamically changing individual...

BACKGROUND People with gambling problems frequently report repeated unsuccessful attempts to change behaviour. Even though a range of behaviour change techniques are available to individuals to reduce gambling harm, they can be challenging to implement or maintain in the moment. The provision of implementation support, tailored for immediate, real-...

Background: People with gambling problems frequently report repeated unsuccessful attempts to change their behavior. Although many behavior change techniques are available to individuals to reduce gambling harm, they can be challenging to implement or maintain. The provision of implementation support tailored for immediate, real-time, individualiz...

This study compared land-based-only gamblers (LBOGs), online-only gamblers (OOGs), and mixed-mode gamblers (MMGs), based on a 2019 Australian national telephone survey (N = 15,000). It examined 1) prevalence, demographics and gambling behaviours, 2) problematic gambling, 3) most harmful gambling forms, 4) gambling-related harms-to-self, and 5) risk...

Background and aims: Individuals impacted by someone else's alcohol, illicit drug, gambling and gaming problems (affected others) experience extensive harms. This is the first systematic review and meta-analysis to determine the effectiveness of psychosocial interventions delivered to affected others across addictions. Methods: This review adher...

Preprint coming soon.

Background Children living with a problem gambling parent are at risk of harm but no previous systematic reviews have specifically focused on the relationship of parental problem gambling and child wellbeing outcomes. The current review aimed to redress this gap by reviewing all available empirical evidence on parental problem gambling and child we...

The aim of this study was to update and expand upon a previous study in 2014 and evaluate how the interactive gambling environment has changed since that time. The report used a multi-stage approach to examine interactive gambling. A literature review, environmental scan, national telephone survey, national online survey of gamblers, longitudinal...

BACKGROUND Many people experiencing harms and problems from gambling do not seek treatment from gambling treatment services due to numerous personal and resource barriers. Mobile health (mHealth) interventions are widely used across a diverse range of health care areas and by various population groups, but there are few in the gambling harm field,...

Background: Many people experiencing harms and problems from gambling do not seek treatment from gambling treatment services due to numerous personal and resource barriers. mHealth interventions are widely used across a diverse range of health care areas and by various population groups. However, there are few in the gambling harm field, despite t...

Gambling in the modern era is pervasive due to the variety of gambling opportunities including use of technology (such as online applications on smartphones). While many people gamble recreationally without undue negative impact, a sizable subset of individuals develop disordered gambling, associated with marked functional impairment including othe...

Background Sexual minority men (SMM) often experience stressful social environments dominated by stigma and discrimination. SMM are typically more likely than heterosexual men to engage in certain risky behaviours such as problem gambling. This study aimed to compare gambling behaviour among SMM and examine potential risk factors (erroneous gamblin...

There are considerable gaps in our understanding of the familial transmission of gambling problems. This convergent mixed-methods study aimed to explore the: (1) sources of heterogeneity in the familial (paternal, maternal, and sibling) transmission of gambling problems; (2) degree to which family-of-origin characteristics are associated with famil...

There is little evidence relating to the effects of adding guidance to internet-based gambling interventions. The primary aim was to compare the effectiveness of an online self-directed cognitive-behavioural gambling program (GamblingLess) with and without therapist-delivered guidance. It was hypothesised that, compared to the unguided intervention...

Background Within psychology, interest in simulation has grown, with publications on role‐play and objective structured clinical examinations emerging. This study examines the impacts of simulation‐based education on students' clinical competence and confidence when compared with traditional case‐based education. The perceived alignment between sim...

Relapse prevention models suggest that positive outcome expectancies can constitute situational determinants of relapse episodes that interact with other factors to determine the likelihood of relapse. The primary aims were to examine reciprocal relationships between situational positive gambling outcome expectancies and gambling behaviour and mode...

Personalized Normative Feedback (PNF) may help address addictive disorders. PNF highlights discrepancies between perceived and actual peer norms, juxtaposed against self-reported behavior. PNF can be self-directed and cost-efficient. Our study estimates the efficacy of PNF alone, and in combination with other self-directed interventions, to address...

Little is known about the cumulative effect of adolescent and young adult mental health difficulties and substance use problems on gambling behaviour in adulthood. We use data from one of Australia’s longest running studies of social and emotional development to examine the extent to which: (1) mental health symptoms (depressive and anxiety symptom...

Background and aim Examining risk‐curves is important to understanding the degree to which indices of gambling consumption are associated with gambling‐related harm. Risk‐curves have largely been described as J‐shaped, suggesting that at low levels of consumption harm remains constant but then increases sharply at a certain threshold. Alternative m...

Background and aims: Problem gambling severity and gambling-related harm are closely coupled, but conceptually distinct, constructs. The primary aim was to compare low-risk gambling limits when gambling-related harm was defined using the negative consequence items of the Problem Gambling Severity Index (PGSI-Harm) and the Short Gambling Harms Scal...

Affected others impacted by someone else’s gambling utilise numerous behaviour change strategies to minimise gambling-related harm but knowledge on what these strategies are and how they are implemented is limited. This study aimed to develop a comprehensive data-driven taxonomy of the types of self-help strategies used by affected others, and to c...

This study derived a set of Australian low-risk gambling limits and explored the relative and absolute risk associated with exceeding these limits. Secondary analysis of population-representative Tasmanian and Australian Capital Territory (ACT) cross-sectional (11,597 respondents) and longitudinal studies (2027 respondents) was conducted. Balancing...

Online chat and email are two of the most popular ways of providing e-mental health. Online chat is synchronous communication in a virtual chat room where client and counselor meet at the same time. In contrast, email is referred to as asynchronous because it can be accessed without the synchronous presence of client and counselor. There has been a...

BACKGROUND Low uptake rates of traditional treatments in the gambling field highlight the need for innovative treatment modalities. Smartphone apps can provide unprecedented access to real-time ecological momentary interventions (EMIs) delivered in people’s everyday lives. OBJECTIVE To examine the acceptability, feasibility, and preliminary effect...

Background Low uptake rates of traditional gambling treatments highlight the need for innovative treatment modalities. Smartphone apps can provide unprecedented access to real-time ecological momentary interventions (EMIs) delivered in people’s everyday lives. Objective This study aims to examine the acceptability, feasibility, and preliminary effe...

Family member’s competing perspectives mean two distinct treatment approaches have developed (i.e., those focusing on the needs of the gambler, or the needs of the family), but little is known of what family members want if offered a choice. A convergent mixed-method design with 62 family members examined the experiences of those seeking help via a...

There is a limited evidence base from which to draw conclusions about compensatory and protective factors for problem gambling. The aim of this study was to explore the potential for positive mental health characteristics (general coping, emotional support, spirituality, interpersonal skills, personal growth and autonomy, and global affect) to play...

Gambling problems commonly co-occur with other mental health problems. However, screening for problem gambling (PG) rarely takes place within mental health treatment settings. The aim of the current study was to examine the way in which mental health clinicians respond to PG issues. Participants (n = 281) were recruited from a range of mental healt...

Aims To explore reciprocal relationships between real-time gambling cravings and self-efficacy with gambling behaviour, and the moderating role of gambling, mental health, and addiction-related variables. Design Secondary analysis of a 4-week Ecological Momentary Assessment (EMA) study conducted in Tasmania, Australia. Setting Data were collected...

Although it is often assumed that electronic gaming machines (EGMs) are associated with the highest level of risk, it has proved difficult to find reliable evidence in support of this proposition. In this paper, we analysed statistics from major Australian community prevalence studies for the period 2011–2020 to investigate whether EGMs (in compari...

Smartphone apps are suitable for delivering mental health treatment in real-time. This study aimed to develop and test the usability of one of the first smartphone app-delivered ecological momentary interventions for gambling (GamblingLess: Curb Your Urge), with key Australian stakeholders (ten consumers, nine gambling clinicians, and ten gambling...

Within psychology, interest in simulation has grown, with publications on role‐play and objective structured clinical examinations emerging. This study examines the impacts of simulation‐based education on students' clinical competence and confidence when compared with traditional case‐based education. The perceived alignment between simulation‐bas...

Background: The low utilisation of current treatment services by people with gambling problems highlights the need to explore new modalities of delivering treatment interventions. This protocol presents the design of a pragmatic randomized control trial aimed at assessing the effectiveness and acceptability of cognitive behavioral therapy (CBT) de...

Gambling exposes people to risk for harm, but also has recreational benefits. The present study aimed to measure gambling harm and gambling benefits on similar scales using two novel methods adapted from the Burden of Disease approach (McCormack et al. in Psychol Med 18(4):1007–1019, 1988; Torrance et al. in Health Serv Res 7(2):118–133, 1972) to f...

Background and objectives: International students comprise an ethnic minority subpopulation who may be at increased risk for the development of gambling problems. This study aimed to explore the psychosocial factors associated with gambling problems in international and domestic university students in Australia. Methods: One hundred seventy-thre...

Background: The Problem Gambling Severity Index (PGSI) was intended for use in epidemiological research with gamblers across the continuum of risk. Its utility within clinical settings, where the majority of clients are problem gamblers, has been brought into question. Aims: (1) Identify refined categories for the problem gambling category of th...

To date, studies have highlighted cross-sectional and unidirectional prospective relationships between problem gambling and mental health symptoms or substance use. The current study aims to: (1) examine the reciprocal relationships between problem gambling and mental health symptoms (depression, generalized anxiety)/substance use variables (hazard...

Non-gambling specialist services, such as primary care, alcohol and other drug use, and mental health services, are well placed to enhance the identification of people with gambling problems and offer appropriate generalist first level interventions or referral. Given time and resource demands, many of these clinical services may only have the capa...

Introduction: Countries with legalized gambling offer a network of government funded face-to-face therapy, but usage of this expertise is on the decline. One way to address this issue is to recruit therapists from existing services whereby they provide guidance for the delivery of internet delivered CBT. Objective: To explore the experiences and...

While the evidence about the statistical co-occurrence of family violence and problem gambling is growing, the mechanism by which the two behaviours are related is less clear. This study sought to clarify the dynamics of the problem behaviours, including the role of gender in victimisation and perpetration of violence in the family. Two-hundred-and...

Although problem gambling and family violence are related, there is little available research exploring the factors associated with this relationship. The primary aim was to predict family violence (victimization and perpetration) in a sample of treatment-seeking gamblers by gambling indices (gambling symptom severity, gambling time spent, gambling...

Addressing gambling problems across a continuum requires understanding of low severity problems, as well as severe levels of problem gambling or disorder. The aims of this study were thus to derive a map of how problematic gambling behaviours and harms are situated across a continuum, and identify the best available indicators of low severity probl...

Despite substantial evidence that problem gambling is associated with a wide range of family difficulties, limited effort has been devoted to studying the negative impacts on family members as a result of problem gambling, particularly in Chinese communities. It was hypothesized that significant negative relationships would be found between family...

Background and aims: Few studies have investigated the association between problem gambling (PG) and violence extending into the family beyond intimate partners. This study aimed to explore the association between PG and family violence (FV) in a population-representative sample. It was hypothesized that: (a) PG would be positively associated with...

Gambling-related cognitions and negative psychological states have been proposed as major factors in the initiation and maintenance of problem gambling (PG). While there are a substantial number of studies supporting the role of cognitive dysfunctions in the initiation and maintenance of PG, very few empirical studies have explored the specific rol...

Very few clinical cognitive-behavioural intervention (CBI) studies were conducted with the Chinese gamblers. There is a lack of attention paid to intervening in negative emotions that may also adversely affect PGs in current CBI treatment modality. This study is the first attempt to systematically and rigorously evaluate both the short-term and lon...

Elevated rates of family violence among treatment-seeking problem gamblers compared to general population estimates have been reported in Spain, Canada and Australia. This study examined the occurrence of family violence among 454 problem gambling help-seeking clients (370 gamblers, 84 affected others) recruited through 3 national gambling treatmen...

Background and aims To date, no systematic approach to identifying the content and characteristics of psychological interventions used to reduce gambling or problem gambling has been developed. This study aimed to develop a reliable classification system capable of identifying intervention characteristics that could, potentially, account for greate...

Research investigating rates of help-seeking for problem gambling has traditionally focused on the uptake of face-to-face gambling services alone, despite the World Health Organisation defining help-seeking as any action or activity undertaken to improve or resolve emotional, psychological or behavioural problems. The primary aim of this study is t...

Despite high rates of comorbidity between problem gambling and mental health disorders, few studies have examined barriers or facilitators to the implementation of screening for problem gambling in mental health services. This exploratory qualitative study identified key themes associated with screening in mental health services. Semi-structured in...

Background and aims Relatively little is known about co-occurring gambling problems and their overlap with other addictive behaviors among individuals attending mental health services. We aimed to determine rates of gambling and substance use problems in patients accessing mental health services in Victoria, Australia. Methods A total of 837 adult...

Background and aims: Despite the over-representation of people with gambling problems in mental health populations, there is limited information available to guide the selection of brief screening instruments within mental health services. The primary aim was therefore to compare the classification accuracy of nine brief problem gambling screening...

SMS is simple, inexpensive and a convenient method of delivering interventions to people with problem gambling, but there are currently no trials investigating its feasibility or impact. This study explores the feasibility of SMS for people with problem gambling accessing an e-mental health service (i.e. chat, email, forums and brief self-help). Th...

Background and objectives: Although parenting practices are articulated as underlying mechanisms or protective factors in several theoretical models, their role in the intergenerational transmission of gambling problems has received limited research attention. This study therefore examined the degree to which parenting practices (positive parentin...

Introduction: The risk for developing a gambling problem is greater among offspring who have a problem gambling parent, yet little research has directly examined the mechanisms by which this transmission of problem gambling occurs. For this reason, the present study sought to examine the degree to which children's expectancies and motives relating...

Research suggests online interventions can have instant impact, however this is yet to be tested with help-seeking adults and in particular those with problem gambling. This study seeks to determine the immediate impact of a single session web-based intervention for problem gambling, and to examine whether sessions evaluated positively by clients a...

Neuroscientific explanations of gambling disorder can help people make sense of their experiences and guide the development of psychosocial interventions. However, the societal perceptions and implications of these explanations are not always clear or helpful. Two workshops in 2013 and 2014 brought together multidisciplinary researchers aiming to i...

Introduction The prevalence of disordered gambling worldwide has been estimated at 2.3%. Only a small minority of disordered gamblers seek specialist face-to-face treatment, and so a need for alternative treatment delivery models that capitalise on advances in communication technology, and use self-directed activity that can complement existing ser...

Online chat and email are two of the most popular ways of providing e-mental health. Online chat issynchronous communication in a virtual chat room where client and counselor meet at the same time.In contrast, email is referred to as asynchronous because it can be accessed without the synchronouspresence of client and counselor. There has been a ra...

The primary aims of this study were to examine the prevalence of personality disorders in problem gamblers, to explore the relationship between personality disorders and problem gambling severity, and to explore the degree to which the psychological symptoms highlighted in the biosocial developmental model of borderline personality disorder (impuls...

Despite substantial evidence that problem gambling is associated with a wide range of family difficulties, limited effort has been devoted to studying the negative impacts on family members as a result of problem gambling and how they cope and function under the impacts of problem gambling in Chinese communities. Among the very few Chinese-specific...

This systematic review aimed to identify early risk and protective factors (in childhood, adolescence or young adulthood) longitudinally associated with the subsequent development of gambling problems. A systematic search of peer-reviewed and grey literature from 1990 to 2015 identified 15 studies published in 23 articles. Meta-analyses quantified...