Transdiagnostic factors in gambling addiction: Emotion regulation and intolerance of uncertainty

This study aimed to determine the prevalence of gambling disorder (GD) risk, associated demographic characteristics, and types of games played among young adults aged 18-32. Furthermore, it sought to examine GD risk within the context of its relationship with transdiagnostic factors, namely emotion dysregulation and intolerance of uncertainty. A mixed sampling method was employed. Snowball sampling (n=475) was used to reach a community-based group, while purposive sampling (n=60) was utilized to focus on individuals at high risk for GD. Participants completed a Demographic Information Form, the Gambling Risk Screening Scale (GRSS), the Difficulties in Emotion Regulation Scale-Short Form (DERS-16), and the Intolerance of Uncertainty Scale-12 (IUS-12). Data analysis involved descriptive statistics, correlation analyses, independent samples t-tests, and matched case-control comparisons. Findings revealed that the high-risk rate for GD in the entire sample was 10.3%. This rate was 3.6% in the snowball group, representing a community sample, and 63.3% in the purposive sample specifically formed for high-risk individuals. Individuals in the high-risk group most frequently played casino games (76.4%) and online sports bets (74.5%), while low-frequency games such as stocks/forex (14.1%) and scratch cards (11.5%) were predominant in the no-risk group. 94.5% of individuals in the high-risk group reported playing at least two different types of gambling games, and as the number of game types played increased, levels of emotion dysregulation (r=.813) and intolerance of uncertainty (r=.501) also increased. Demographic analyses indicated significant relationships between GD risk and male gender, older age (within the young adult range), higher personal and family income, and lower paternal education level. Findings concerning transdiagnostic variables showed that the positive relationships between GD risk, emotion dysregulation, and intolerance of uncertainty were stronger and more comprehensive (across all subscales) in the high-risk clinical (purposive) sample. In the community (snowball) sample, these relationships were limited only to the "impulse control" and "non-acceptance of emotions" subscales of emotion dysregulation. Matched case-control analysis results confirmed that individuals at high risk for GD had significantly higher levels of both emotion dysregulation and intolerance of uncertainty compared to individuals with no risk. The largest effect sizes were observed for the "impulsivity" subscale of emotion dysregulation and the "inhibitory" (inability to stop behavior) subscale of intolerance of uncertainty. In conclusion, this study demonstrates that GD is a significant public health issue among young adults and reveals a clear distinction between pathological and recreational gambling profiles in terms of the diversity and types of games played. The findings point to the significance of emotion dysregulation (particularly impulsivity) and dysfunctional coping responses to uncertainty (impulsive action) as underlying psychological mechanisms of GD. These results support the notion that interventions for the prevention and treatment of GD should adopt holistic, process-based approaches focusing on these transdiagnostic psychological processes, rather than targeting the behavior alone.