Table of Contents Abstract .................................................................................................................................... 5 1. Executive Summary .......................................................................................................... 6 1.1 Key Objectives of the Framework ................................................................................. 6 1.2 Defining Harmful Gambling........................................................................................... 8 1.3 Value of the Framework ..............................................................................................10 1.4 Overview of the Framework .........................................................................................12 1.5 Relevance of Framework to Stakeholders ...................................................................14 1.6 Conceptual Framework Diagram .................................................................................15 2. Discussion of Gambling-specific Factors Contributing to Harmful Gambling ...........16 2.1 Gambling Environment ................................................................................................16 2.1.1 Economics ............................................................................................................17 2.1.2 Socio-Political Environment ..................................................................................19 2.1.3 Public Policy ..........................................................................................................20 2.1.4 Culture of Social Responsibility .............................................................................24 2.2 Gambling Exposure .....................................................................................................25 2.2.1 Gambling Setting ..................................................................................................27 2.2.2 Accessibility ..........................................................................................................29 2.2.3 Adaptation .............................................................................................................31 2.2.4 Marketing and Messaging .....................................................................................32 2.3 Gambling Types ..........................................................................................................35 2.3.1 Structural Characteristics ......................................................................................36 2.3.2 Motivations for Gamblers ......................................................................................38 2.3.3 Risk Assessment ..................................................................................................41 2.4 Gambling Resources ...................................................................................................42 2.4.1 Service Utilization .................................................................................................42 2.4.2 Protection, Prevention, and Harm Reduction ........................................................43 2.4.3 Interventions .........................................................................................................45 3. Discussion of General Factors Contributing to Harmful Gambling .............................48 3.1 Cultural Factors ...............................................................................................................48 3.1.1 Ethnicity and Traditions .........................................................................................49 3.1.2 Indigenous Groups ................................................................................................51 3.1.3 Socio-cultural Attitudes .........................................................................................55 3.1.4 Religion and Other Belief Systems .......................................................................57 3.1.5 Gender ..................................................................................................................58 3.2 Social Factors ..............................................................................................................59 3.2.1 Social Demographics ............................................................................................61 3.2.2 Family and Peer Gambling Involvement ...............................................................61 3.2.3 Education System .................................................................................................63 3.2.4 Neighbourhood .....................................................................................................63 3.2.5 Stigmatization .......................................................................................................65 3.2.6 Deviance ...............................................................................................................66 3.3 Psychological Factors ..................................................................................................67 3.3.1 Personality and Temperament ..............................................................................67 3.3.2 Self-perceptions ....................................................................................................68 3.3.3 Social Learning .....................................................................................................68 3.3.4 Lifespan Development ..........................................................................................69 3.3.5 Co-morbid Disorders .............................................................................................70 3.3.6 Subjective Well-Being ...........................................................................................70 3.3.7 Coping Styles ........................................................................................................70 3.3.8 Judgement and Decision Making ..........................................................................71 3.4 Biological Factors ........................................................................................................71 3.4.1 Genetic Inheritance ...............................................................................................71 3.4.2 Neurobiology .........................................................................................................73 Author Biographies ................................................................................................................76 Summary of Existing Research that Informed Our Work ....................................................83 Future Research Directions ...................................................................................................87 References ..............................................................................................................................91 Additional Resources ...........................................................................................................130 Abstract Although it is seen by many as a form of leisure and recreation, gambling can have serious repercussions for individuals, families, and society as a whole. The harmful effects of gambling have been studied for decades in an attempt to understand individual differences in gambling engagement and the life-course of gambling-related problems. In this publication, we present a comprehensive, internationally relevant conceptual framework of “harmful gambling” that moves beyond a symptoms-based view of harm and addresses a broad set of factors related to population risk, community and societal effects. Interactive factors depicted in the framework represent major themes in gambling that range from specific (gambling environment, exposure, types, and resources) to general (cultural, social, psychological, and biological). The framework has been created by international interdisciplinary experts and stakeholders— including researchers, treatment providers, operators, policy makers, as well as individuals and their families—in order to facilitate an understanding of harmful gambling. It reflects the state of knowledge related to factors influencing harmful gambling; and serves a secondary purpose as a guide for the development of future research programs and education of policy makers on issues related to harmful gambling. Gambling Research Exchange Ontario (GREO) (formerly the Ontario Problem Gambling Research Centre (OPGRC) located in Guelph, Ontario, Canada) has facilitated the development of the Conceptual Framework of Harmful Gambling and will retain responsibility for keeping it up-to-date. Please cite as: “Abbott, Max; Binde, Per; Clark, Luke; Hodgins, David; Korn, David; Pereira, Alexius; Quilty, Lena; Thomas, Anna; Volberg, Rachel; Walker, Douglas; Williams, Robert. (2015). Conceptual Framework of Harmful Gambling: An International Collaboration Revised Edition. Gambling Research Exchange Ontario (GREO), Guelph, Ontario, Canada.” Gambling Research Exchange Ontario (GREO) received funding support from the Ontario Ministry of Health and Long Term Care (MOHLTC). The views expressed are the views of the authors, and do not necessarily reflect those of GREO, MOHLTC, or the province of Ontario. Commercial use of this document is prohibited without written consent from the Gambling Research Exchange Ontario (GREO). 1. Executive Summary Gambling is a human activity with a long history. Even now, the