The role of craving in gambling behavior: examining its relevance and links to psychological distress, personality, and demographics

Several studies have sought to investigate gambling craving and its potential contribution to gambling problems. One aim of this line of research has been to further examine whether craving should be considered a separate diagnostic criterion for gambling disorder, which it currently is not. The present study aimed to investigate the relationship between craving and other risk factors—such as mental health symptoms, affect, and personality traits—and to determine whether craving makes a unique contribution to problematic gambling when controlling for these factors. In total, 1053 Swedish adult gamblers (55% male, median age 48.4 years) from a citizen panel completed a web survey including: Gambling Craving Scale (subscales desire, relief, and anticipation), Diagnostic Screen for Gambling Problems (NODS), and other scales. According to NODS, classification, 81% were non-problem gamblers, 11% at-risk gamblers, 4% problem gamblers, and 4% were classified as having probable gambling disorder. We conducted Spearman correlation analysis of the relationship of craving with gambling severity and other risk factors, and logistic regression exploring craving’s impact in problematic gamblers while controlling for risk factors. The three craving subscales were strongly associated with gambling severity and weakly–moderately associated with mental health symptoms, negative affects, and the personality traits impulsivity, negative affectivity, antagonism, and alexithymia; the subscales were slightly–moderately negatively associated with positive affects and the personality trait hedonic capacity. When exploring craving’s impact on problematic gambling, controlling for mental health symptoms, affects, personality traits, age, and gender, the subscales desire and anticipation, alongside impulsivity and being male, increased the odds of problematic gambling. These findings suggests that craving, alongside impulsivity and male gender, is central to understanding problematic gambling, implying that prevention and treatment efforts should address these targets, and further support the inclusion of craving in future revision of diagnostic criteria for gambling disorder.