Dowling Nicki A, Merkouris Stephanie S, Spence Kimberley
School of Psychology, Deakin University, Geelong, VIC 3220, Australia.
Melbourne Graduate School of Education, University of Melbourne, Parkville, VIC 3053, Australia.
J Clin Med. 2021 Apr 15;10(8):1709. doi: 10.3390/jcm10081709.
Relapse prevention models suggest that positive outcome expectancies can constitute situational determinants of relapse episodes that interact with other factors to determine the likelihood of relapse. The primary aims were to examine reciprocal relationships between situational positive gambling outcome expectancies and gambling behaviour and moderators of these relationships. An online survey and a 28 day Ecological Momentary Assessment (EMA) were administered to 109 past-month gamblers (84% with gambling problems). EMA measures included outcome expectancies (enjoyment/arousal, self-enhancement, money), self-efficacy, craving, negative emotional state, interpersonal conflict, social pressure, positive emotional state, financial pressures, and gambling behaviour (episodes, expenditure). Pre-EMA measures included problem gambling severity, motives, psychological distress, coping strategies, and outcome expectancies. No reciprocal relationships between EMA outcome expectancies and gambling behaviour (episodes, expenditure) were identified. Moderations predicting gambling episodes revealed: (1) cravings and problem gambling exacerbated effects of enjoyment/arousal expectancies; (2) positive emotional state and positive reframing coping exacerbated effects of self-enhancement expectancies; and (3) instrumental social support buffered effects of money expectancies. Positive outcome expectancies therefore constitute situational determinants of gambling behaviour, but only when they interact with other factors. All pre-EMA expectancies predicted problem gambling severity (OR = 1.61-3.25). Real-time interventions addressing gambling outcome expectancies tailored to vulnerable gamblers are required.
预防复发模型表明，积极的结果预期可能构成复发事件的情境决定因素，这些因素与其他因素相互作用，以确定复发的可能性。主要目的是研究情境性积极赌博结果预期与赌博行为之间的相互关系，以及这些关系的调节因素。对109名过去一个月内有赌博行为的人（84%有赌博问题）进行了在线调查和为期28天的生态瞬时评估（EMA）。EMA测量包括结果预期（享受/兴奋、自我提升、金钱）、自我效能感、渴望、负面情绪状态、人际冲突、社会压力、积极情绪状态、财务压力和赌博行为（次数、支出）。EMA前的测量包括问题赌博严重程度、动机、心理困扰、应对策略和结果预期。未发现EMA结果预期与赌博行为（次数、支出）之间存在相互关系。预测赌博次数的调节因素显示：（1）渴望和问题赌博加剧了享受/兴奋预期的影响；（2）积极情绪状态和积极重新构建应对方式加剧了自我提升预期的影响；（3）工具性社会支持缓冲了金钱预期的影响。因此，积极的结果预期构成了赌博行为的情境决定因素，但只有在它们与其他因素相互作用时才成立。所有EMA前的预期都预测了问题赌博的严重程度（OR = 1.61 - 3.25）。需要针对易受影响的赌徒，开展针对赌博结果预期的实时干预措施。
