The WAGER, Vol. 18(1) - Disorder or distraction? Experiential Avoidance and problem gambling behaviors

Experiential avoidance (EA) refers to an individual’s attempt to avoid internal experiences related to an event, such as thoughts, feelings, and physical sensations, by engaging in some other activity (Riley 2012). Researchers have suggested that people can engage in EA through a number of activities, including sex, drug use, exercise, and gambling (Riley 2012). EA might therefore be related to the development of gambling problems. This week’s WAGER reviews a study that explored the relationship between EA and problem gambling, as well as the relationships between these constructs and related constructs: thought suppression and mindfulness (Riley 2012).  

Methods

A convenience sample of 103 treatment-seeking problem gamblers from an outpatient facility in South Australia completed a battery of measures to assess their levels of problem gambling and mindfulness, their tendency to suppress difficult thoughts, and their inability to take action when faced with “negatively evaluated private events.” Participants completed the following measures:

• Dispositional EA: Acceptance and Action Questionnaire (AAQ-II; Bond et al. 2011)[1]
  • In this scale, higher scores indicate lower levels of EA.
• Dispositional thought suppression: White Bear Suppression Inventory (WBSI; Wegner and Zanakos 1994)[2]
• Dispositional mindfulness: Mindfulness and Attention Awareness Scale (MAAS; Brown and Ryan 2003)[3]
• Problem gambling symptomology: Problem Gambling Severity Index (PGSI; Ferris and Wynne 2001)[4]

The researchers completed multiple regression analyses to explore the relationships among problem gambling, thought suppression, and mindfulness; and, to examine whether EA mediated a relationship between thought suppression and problem gambling.

Results

Table 1 below shows the relationship (zero order correlations) between the variables in question. Thought suppression and experiential avoidance were positively associated with problem gambling (r’s = .33 and -.43; both p’s < .01). Mindfulness, on the other hand, was negatively associated with problem gambling (-.39; p < .001).  

Table 1: Zero order correlations of study variables. (This table is adapted from the original article).

	Experiential avoidance	Problem gambling	Mindfulness	Thought suppression
Experiential avoidance	-	-.43; p < .001	.51; p < .001	-.63; p < .001
Problem gambling	-	-	-.39; p < .001	.33; p < .01
Mindfulness	-	-	-	.48; p < .001
Thought suppression	-	-	-	-

The researchers conducted linear regression analyses to examine potential mediating relationships. As shown in Tables 2 and 3, EA appears to mediate the relationships between both thought suppression and mindfulness with problem gambling. When controlling for EA, the standardized regression coefficients between the other variable (mindfulness or thought suppression) and problem gambling decreased and became non-significant.

Table 2: Linear Regression with Problem Gambling as the dependent variable w/ thought suppression and experiential avoidance as independent variables

	B	Standardized B	p	Sobel z;
Thought supression	0.04	0.11	0.91	2.73; p < .001
Experiential avoidance	-0.15	-0.35	0.22

Table 3: Linear Regression with Problem Gambling as the dependent variable w/ mindfulness and experiential avoidance as independent variables

	B	Standardized B	p	Sobel z
Mindfulness	-0.82	-0.19	.085	-2.82; p < .001
Experiential avoidance	-0.15	-0.35	.001

Limitations

• The study may not be generalizable to other populations.
  • 103 is a relatively small sample size and all individuals came from the same outpatient facility in South Australia
  • The researchers used a convenience sample so the results may not be applicable to all problem gamblers
    • The participants were treatment seeking problem gamblers, perhaps those individuals for whom EA functions differently would not be seeking treatment.
• Due to the cross-sectional nature of the analysis it is not possible to determine causal relationships between EA, thought suppression, and mindfulness and problem gambling.

Discussion

This article suggests that pathological gambling is related to experiential avoidance and thought suppression. The mediational findings suggest a model whereby people experience intrusive thoughts and attempt to cope with the distress these thoughts cause by gambling. A more mindful state, however, might decrease the urge to escape distress and gamble. These models can be applied to more targeted, and therefore more effective, gambling treatments. Specifically, incorporating mindfulness-based therapies and acceptance practices into gambling recovery might help counteract experiential avoidance and draw into focus the underlying problem that is leading to the problematic behavior.

- Emily Shoov

What do you think? Please use the comment link below to provide feedback on this article.

References

Bond, F. W., Hayes, S. C., Baer, R. A., Carpenter, K. C., Guenole, N., Orcutt, H. K., et al. (2011). Preliminary psychometric properties of the acceptance and action questionnaire—II: A revised measure of psychological flexibility and acceptance. Behavior Therapy, 42, 676–688.

Brown, K. W., & Ryan, R. M. (2003). The benefits of being present: Mindfulness and its role in psychological well-being. Journal of Personality and Social Psychology, 84(4), 822–848.

Ferris, J. A., & Wynne, H. J. (2001). The Canadian problem gambling index: Final report. Canada: Canadian Centre on Substance Abuse.

Marotta, J. J. (2002). Experiential avoidance as a functional process of problem gambling. In Marotta, J. J., Cornelius, J. A., & Eadington, W. R. (Eds.), The downside of problem and pathological gambling (pp. 69–91). Reno, Nevada, USA: University of Nevada Press.

Riley, B. (2012). "Experiential Avoidance Mediates the Association Between Thought Suppression and Mindfulness with Problem Gambling." Journal of Gambling Studies.. Epub 30 October 2012.

Wegner, D. M., & Zanakos, S. (1994). Chronic thought suppression. Journal of Personality, 62(4), 615–640.

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[1] A 10-item self-report measuring “an individual’s tendency to make negative evaluations of unwanted private events, unwillingness to be in contact with them and a desire to alter their form or frequency to the extent that they are unable to take action in the face of such events.”

[2] A 15-item self-report measuring “an individual’s tendency to suppress unwanted negative thoughts.”

[3] A 15-item self-report measuring “an individual’s dispositional mindfulness” (i.e., the existence or absence of an individual’s “attentional presence” to an experience)

[4] A 9 item self-report measure of problem gambling. 4 items that assess problem gambling behaviors and 5items  that assess consequences of gambling.

Comments

[Mary L. Thorne]

Can you give some examples of "mindful-based" therapies, and how one would implement them if one has a gambling problem? I am a layperson, and I am interested in helping a gambler recover. Thank you.

[Emily]

Hi Mary,

Mindfulness-based therapies are part of the newer wave of psychology and have been around since the 1970s. However, mindfulness has been around for centuries, just packaged differently. These therapies draw heavily from long- and well-established Eastern meditation practices. Mindfulness as a concept refers to nonjudgmental awareness, acceptance, and “presentness” in the moment where your complete attention is given to the present moment.

Current therapies that include a mindfulness component include:

Mindfulness-based Stress Reduction
Mindfulness-based cognitive therapy (MBCT) for depression
Gestalt therapy
Adaptation Practice
Dialectical behavior therapy
Acceptance and commitment therapy
And more recently mindfulness-based relapse prevention (MBRP) in substance use disorders.

There has been some research to suggest that mindfulness-based cognitive therapy (MBCT) might be helpful with gambling-related problems. It helps promote acceptance of distressing thoughts and emotions.

The article from the WAGER talks about experiential avoidance, which is essentially the opposite of what mindfulness targets. Instead of ignoring unpleasant thoughts or impulses and trying to distract yourself (e.g., with gambling) mindfulness-based approaches suggest that you take the time, without judgment, to think through those thoughts and acknowledge that you have them. The “no judgment” component is arguably the most important when confronting potentially unpleasant thoughts and urges, and can be difficult at first.

I found you an article presenting a case study where they attempt to use MBCT for a problem gambler which is available online if you’re interested in reading about an example: http://ccs.sagepub.com/content/10/3/210.full.pdf+html
In this instance, her therapy included keeping a daily diary that chronicled “date, mindfulness practice, practice duration, and comments.”

Thank you for your interest in the WAGER and for your question!

Emily