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Published on: November 9, 2019
Gambling Modality and Financial Harm among People Seeking Help for Gambling Disorder in South Korea
Introduction:
Online-offline gambling comparisons rarely distinguish debt occurrence from debt amount. Problem-stage gambling modality and recalled modality pathways were examined in relation to symptom severity and gambling-related debt.
Methods:
This retrospective cross-sectional study analyzed 2019-2024 intake records from South Korea's national gambling counseling service. The sample comprised 567 help-seeking individuals meeting DSM-5 criteria for gambling disorder. Regression models examined DSM-5 criterion count, Problem Gambling Severity Index (PGSI) score, any debt, and debt amount among those with debt. Models adjusted for age, sex, assessment year, product group, and legal status. Additional analyses examined modality pathways, recalled age at first gambling, and age-related differences.
Results:
At the problem stage, 89.8% reported online gambling. Among 553 participants in three modeled pathways, 9.4% were persistent offline, 14.1% migrated online, and 76.5% were persistent online. Fully adjusted models showed no clear online-offline differences in DSM-5 criterion count, PGSI score, or any debt. Among 242 complete cases with debt, adjusted mean debt was twice as high online as offline (ratio 2.00, 95% CI 1.11-3.62). Persistent-online participants also had higher debt than persistent-offline participants (ratio 2.56, 95% CI 1.32-4.95). Online gambling was associated with greater recent gambling intensity. Persistent-online participants reported a younger recalled age at first gambling. An exploratory interaction suggested a larger online-offline debt ratio at older ages.
Conclusion:
Online gambling was associated with larger debt among participants with debt, despite no clear differences in symptom severity or debt occurrence. Clinical assessment should record debt amount alongside symptom severity and modality history.
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