Belle Gavriel-Fried

Compulsive Sexual Behavior Disorder (CSBD) was officially classified as an Impulse Control Disorder in the 11th revision of the International Classification of Diseases (World Health Organization, ...

Introduction: Gambling disorder (GD) is characterized by persistent gambling behavior associated with significant distress and functional impairment. Pathways to GD reflect a complex interplay of individual, environmental, and experiential factors. United States (U.S.) veterans are considered particularly vulnerable due to heightened exposure to trauma and cumulative life stressors. In a qualitative study examining barriers to treatment among veterans, participants described various risk factors contributing to GD, prompting a secondary analysis to better identify the unique risk factors shaping the pathways leading U.S. military veterans and service members to develop and persist in GD. Methods: Participants included 28 U.S. service members and veterans (8 women; aged 27–73, M _age = 46.5) recruited in the primary study. Semi-structured interviews were conducted via Zoom and included an assessment of GD diagnostic criteria (past year and 10-year history). A combination of secondary analysis and a theory-informed approach was employed, using the Pathways Model of Problem and Pathological Gambling as the overarching theoretical framework. In practice, the analysis combined deductive and inductive approaches to content analysis. Results: Three main themes were revealed, each representing a specific life period: childhood, military service, and civilian life. The themes included: a) life history of vulnerability and yearning for change; b) the broken promise: the military as a multidimensional risk for developing gambling problems; and c) sinking deeper into gambling in the post-military period. While these themes corresponded with the second subtype of the Pathways Model—emotional vulnerability—they primarily illustrate the dynamic interplay between individual vulnerability and the changing socio-cultural and environmental contexts across the participants’ life stages and turning points. Discussion: Integrating the Pathways Model with a life-course perspective, findings underscore the dynamic interplay between individual vulnerability and environmental context in shaping GD trajectories across veterans’ life stages. Rather than disrupting risk, key transitions may reinforce maladaptive patterns over time. Future studies should incorporate a life-course perspective into the theoretical framework of the Pathways Model of problem gambling.

This study explored the perspectives of social workers from addictions field regarding payment for sex (PS) and the associations with self-efficacy, comfort to discuss sexual issues in treatment (CDSIT), and attitudes toward social justice, toward people who receive payment for sex (PRPS) and toward PS. Participants (N = 123) completed an online questionnaire. Main findings showed that while most acknowledge the significance of addressing PS with clients with substance use disorder, they often did not do so in practice. Attitudes toward social justice, attitudes toward PRPS (perceived as victims rather than choosers), and CDSIT were key predictors.

Globally, 46.2% of all adults report having gambled in the previous 12 months. While most experience no negative repercussions from gambling, individuals who are highly engaged in gambling are at greater risk of problem gambling (PG). Studies point to the psycho-social, environmental, and socio-demographic risk factors associated with gambling and PG, and the associated harm to individuals, families, and society, making it a public health concern worldwide. Israel has a relatively regulated conservative gambling market where casinos and electronic gambling machines are banned, and online gambling is only permitted for sports betting. Nevertheless, Israel has a relatively high percentage of PG. This study was designed to characterize involvement in gambling behavior during the previous year in non-gamblers, low-frequency, and high-frequency gamblers as a function of socio-demographic, health, and psycho-social risk and protective factors, and differentiate between problem and non-problem high-frequency gamblers. A representative sample of 3224 Israeli Jews and Arabs filled in an online questionnaire in 2022. The findings showed that 50.7% were non-gamblers, 33.8% were low-frequency gamblers, and 15.5% were high-frequency gamblers. Compared to non-gamblers, low-frequency and high-frequency gamblers were associated with Jewish ethnicity, low levels of financial self-efficacy and neighborhood cohesion, a greater likelihood to smoke and drink, and having a significant other (family/social network member) with perceived excessive gambling. Male gender and traditional self-perceived religiosity were associated with both low-frequency and high-frequency gamblers as well, but to a greater extent with high-frequency than low-frequency gamblers. Online gambling, stress, low financial self-efficacy, using social welfare allowances for gambling, having a significant other who engages in perceived excessive gambling, and identifying as an Israeli Arab were all associated with PG in high-frequency gamblers. These findings suggest that despite its conservative regulated market, gambling in Israel exceeds international averages. The similarities between low-frequency and high-frequency gamblers in terms of risk factors may hint at a type of gambling normalization. Regulatory reforms informed by public health policies are recommended to decrease access to gambling, including banning online gambling and curbing special gambling offers timed to coincide with welfare payments. Awareness campaigns, culturally sensitive prevention programs are recommended, as well as studies to monitor gambling harm.

Gambling disorder (GD) poses a significant public health problem, with treatment access frequently hindered by barriers. This study sought to identify the unique internal and external barriers encountered by military personnel with GD using a qualitative descriptive method. Twenty-eight United States military veterans and service members (SMs) were recruited through purposeful sampling strategies and interviewed using a semi-structured interview format. Content analysis revealed two main themes: “Emotional Suppression in Military Culture” reflecting military cultural norms that emphasize strength, discipline, and emotional control, which were internalized by the participants and created significant internal barriers; “Structural Ignorance of Gambling Problems” uncovers external barriers such as the normalization of gambling, insufficient recognition of gambling’s addictive nature within military and Veterans Affairs (VA) settings, and inadequate treatment options within the VA healthcare system. The study underscores the complex interplay between cultural norms and institutional practices and proposes policy recommendations to improve help-seeking behaviors for veterans and SMs.

Closed religious communities cultivate a robust communal identity, shared faith, values, and norms among their members, providing them with social and emotional support. Deviance carries significant consequences, specifically disintegrating members’ sense of belonging. Gambling disorder (GD) is characterized by harmful gambling behaviors that negatively affect individuals’ lives. While gambling is a prevalent recreational activity, within closed religious communities, addiction, including GD, is viewed as a violation of religious teachings, values, and communal norms. This study explores GD's impact on the sense of belonging of Jewish Ultra‐Orthodox men and their spouses in Israel. This research employed constructivist grounded theory, interviewing twenty‐two men with GD and eleven spouses and uncovered two complementary themes. The first, “Depleting versus replenishing of the personal aspects of sense of belonging,” elucidates GD's different effects on the men and spouses’ sense of belonging. The second, “Paying the toll,” illuminates the emotional experiences and actions of the men and the spouses in reaction to societal conditional negative regard directed at them, disintegrating the sense of belonging of the men, but also that of the spouses who did not deviate from communal norms. The paper introduces the novel concept of “an empty pool/pull,” portraying these individuals’ limbo state. The “empty pool” represents the depletion of faith, adherence to religious commandments, and communal values for the men, while the “empty pull” signifies the inclination of the men and the spouses to conform amid the community's unfulfilled promise of protection. The study advocates for further research and offers clinical insights for therapists.

Purpose of Review: Gambling disorder (GD) presents significant psychiatric challenges, particularly for vulnerable populations like military veterans, who often also face mental health comorbidities. Recovery is a crucial issue in the gambling field, representing a transition from illness to health. Currently, there is no consensus regarding its definition. This scoping review aimed to map the characteristics of studies on recovery in veterans with GD, explore how it is defined and measured, identify the dominate recovery approach, and the main research topics. Recent Findings: This review identified 13 scientific articles. Findings showed minimal explicit use of the term “recovery” by researchers. The main recovery approach is the deficit based. Most studies focused on treatment programs and their effectiveness, neglecting the unique characteristics of veterans and alternative recovery pathways. Summary: Future studies should explore and conceptualize recovery in veterans, and inquire into the specific recovery needs of veterans living with GD.

Women in recovery from substance use disorder (SUD) face multiple, specific challenges. Establishing healthy and close relationships can contribute to women’s mental health and enhance their recovery. Unhealthy relationships with men are a key factor in women’s onset of drug use, relapse, and attempts to recover from a SUD. Given their frequent personal history of sexual trauma, violence, and abuse caused by men, women recovering from SUD need to cope with multiple relational issues. This study explored the perceptions and experiences of women in recovery from SUD as regards their relationships with men. Fourteen women treated in women-only residential programs for SUD were interviewed using a qualitative-naturalistic approach. Inductive content analysis identified four categories: (1) From disgust and mistrust to attraction to boys and men in the context of abuse, (2) Exploitative relationships: use and be used, (3) The absent predator: justifications for the absence of men in women-only residential treatment program, and (4) Old patterns alongside new insights into recovery. These categories were contextualized conceptually in terms of the dialectic between “Respect and Suspect”. The findings, as interpreted through the lens of Relational Agency theory, highlight changes in power dynamics within relationships over the course of recovery. Clinical social workers should be aware of the multifaceted nature of attitudes towards relationships with men in women with SUD, to better help these women establish healthier, more secure relationships as a part of their recovery.

Growing concerns over gambling problems across age groups have sparked research in public health and psychology. During emerging adulthood, individuals are more susceptible to mental health problems and more likely to develop gambling problems than in other age groups. This study explored the potential differences between emerging adults and adults aged 30+ in terms of problem gambling severity (PGS), gambling-related harm (GRH), depression and anxiety, and the mediating role of depression and anxiety in the association between age, PGS, and GRH. A representative online sample of 3244 Israelis aged 18 and over was divided into two groups: 740 emerging adults aged 18–29 and 2504 adults aged 30+. Gambling behaviors, the Problem Gambling Severity Index, the Short Gambling Harm Screen, and the Patient Health Questionnaire-4 assessing depression and anxiety were administered. Emerging adults had significantly higher levels of GRH, PGS, and depression-anxiety than their older counterparts, above and beyond gender and education. Depression-anxiety fully mediated the associations between age and gambling-related outcomes. These findings underscore the importance of considering psychological well-being in efforts to address problem gambling and gambling-related harms, especially in emerging adults.