Gambling-related cognitive distortions mediate the relationship between depression and disordered gambling severity

Symptoms of depression are highly prevalent among individuals with gambling disorder, and severity of depression is associated with severity of gambling problem. Yet, little is known about the psychological mechanisms by which symptoms of depression lead to greater gambling severity. In this study, we tested whether cognitive distortions represent one such mechanism, as cognitive distortions are key characteristics in both depression and gambling disorder and have been shown to be associated with gambling severity.

A mediation model was tested among 345 treatment-seeking individuals with gambling disorder in Sao Paulo, Brazil. The diagnosis of gambling disorder was made using semi-structured clinical interviews and participants completed psychometrically sound self-report measures of depression symptoms (Beck Depression Inventory-I), gambling-related cognitive distortions (Gamblers' Beliefs Questionnaire), and gambling severity (Gambling Symptom Assessment Scale).

As hypothesized, increased symptoms of depression were significantly associated with both increased disordered gambling severity and increased gambling-related cognitive distortions. Further, gambling-related cognitive distortions predicted greater disordered gambling severity when controlling for depression symptomology. Results from the bootstrapping method indicated that the relationship between symptoms of depression and increased disordered gambling severity is mediated by gambling-related cognitive distortions.

Consistent with our predictions, gambling-related cognitive distortions mediated the relationship between depression symptoms and gambling severity among a sample of treatment-seeking disordered gamblers. These results suggest that cognitive distortions may be a key intervention target for the treatment of concurrent depression and gambling disorder.