Publikationen im Rahmen der LSG


Schwarzkopf, L., Bickl, A., Daniel, J., Papastefanou, G., Neyer, M. A., Gomes de Matos, E., Hoch, E., Olderbak, S., Kraus, L., & Loy, J. K. (2024). Do breaks in online gambling affect neuropsychological arousal? Conceptual approach and lessons learned from the TESSA-pilot trial. Addictive Behaviors Reports, 19, 100530.

Introduction Mandatory breaks have been discussed as a harm reduction strategy in the context of gambling for several years, but their effectiveness remains unclear. The TESSA pilot study examines the association of physiological arousal (PA) and mandatory breaks during gambling with an aim to conceptualize the framework for a subsequent randomized controlled trial. Material and methods In a one-armed experimental pilot study 28 participants engaged in a simulated online slot game with mandatory breaks. PA, disentangled into fear, anger, joy, attraction, balance, and retraction, was continuously monitored via skin conductivity and skin temperature. The occurrence of PA in distinct phases (phase 1: initiation, phase 2: pre-break, phase 3: post-break) was contrasted by multilevel logistic regression. Results Fear and attraction did not change. Compared to phase 1, anger (OR = 0.698; p = 0.015) and joy (OR = 0.714; p = 0.032) were less likely in phase 2, with joy also being less likely in phase 3 (OR = 0.690; p = 0.023). Balance was more likely in phase 2 (OR = 5.073; p < 0.0001) than in phase 1 and less likely in phase 3 (OR = 0.348; p < 0.0001) whilst retraction declined from phase to phase. Discussion Mandatory breaks appear suited to offset changes in PA response evolving during gambling, but a sustained effect on initial PA levels should not to be expected. However, to sensitively judge the role of breaks additional framework conditions that impact on gambling behavior (e. g. wins/losses) should be considered.


Wullinger, P. M., Bickl, A. M., Loy, J. K., Kraus, L., & Schwarzkopf, L. (2023). Longitudinal associations between psychiatric comorbidity and the severity of gambling disorder: Results from a 36-month follow-up study of clients in Bavarian outpatient addiction care. Journal of Behavioral Addictions, 12(2), 535-546.

Background and aims: Individuals with gambling disorder (GD) often suffer from psychiatric comorbidities. Previous studies demonstrated greater severity of GD among gamblers with psychiatric comorbidities. However, evidence on the association between psychiatric comorbidity and course of GD severity during and after outpatient treatment is sparse. This study analyses data from a longitudinal one-armed cohort study on outpatient addiction care clients over three years.

Methods: We investigated the course of GD severity using data from 123 clients in 28 outpatient addiction care facilities in Bavaria using generalized estimation equations (GEE). We applied time* interaction analyses to examine different development profiles in participants with and without (1) affective disorders, or (2) anxiety disorders, and (3) to account for the co-occurrence of both.

Results: All participants benefitted from outpatient gambling treatment. Improvement in GD severity was poorer in participants with anxiety disorders compared to participants without anxiety disorders. The co-occurrence of affective and anxiety disorders was linked to a less favourable course of GD than the presence of affective disorders alone. However, the combined occurrence of both disorders was more favourable than the presence of anxiety disorders alone.

Discussion and conclusions: Our study suggests that clients with GD, with and without psychiatric comorbidities, benefit from outpatient gambling care. Psychiatric comorbidity, especially comorbid anxiety disorders, seems to be negatively associated with the course of GD within outpatient gambling care. Addressing psychiatric comorbidity within the treatment of GD and offering individualised help are required to meet the needs of this clientele.

Bickl, A. M., Kraus, L., Loy, J. K., Kriwy, P., Sleczka, P., & Schwarzkopf, L. (2023). Development of gambling behaviour and its relationship with perceived social support: a longitudinal study of young adult male gamblers. Journal of Gambling Studies.

Young adult men who gamble frequently face an elevated risk of developing gambling-related problems. So far, little is known about how changing levels of perceived social support interact with the course of gambling behaviour and gambling-related problems in this population. Using data from a prospective single-arm cohort study (Munich Leisure Time Study), we applied hierarchical linear models to investigate the longitudinal association of changes in perceived emotional and social support (hereafter PESS; operationalized as ENRICHD Social Support Instrument score) with gambling intensity, gambling frequency, and fulfilled criteria for gambling disorder. Pooling data from three time points (baseline, 12-month and 24-month follow-ups) to assess two 1-year intervals, these models disentangle the associations of (a) “level of PESS” (cross-sectional, between participants) and (b) “changes in individual PESS” (longitudinally, within-participants). Among the 169 study participants, higher levels of PESS were associated with fewer gambling-related problems (− 0.12 criteria met; p = 0.014). Furthermore, increasing individual PESS was associated with lower gambling frequency (− 0.25 gambling days; p = 0.060) and intensity (− 0.11 gambling hours; p = 0.006), and fewer gambling-related problems (− 0.19 problems; p < 0.001). The results suggest a mitigating influence of PESS on gambling behaviour and gambling-related problems. Increasing individual PESS appears more decisive for this pathway than high initial levels of PESS. Treatment and prevention strategies that activate and reinforce beneficial social resources in people with gambling-related problems are recommended and promising.

Kraus, L., Bickl, A., Sedlacek, L., Schwarzkopf, L., Örnberg, J. C., & Loy, J. K. (2023). ‘We are not the ones to blame’. Gamblers’ and providers’ appraisal of self-exclusion in Germany. BMC Public Health, 23(1), 322.

Background Given low utilization by individuals experiencing gambling problems the potential of self-exclusion (SE) might be not fully exploited in Germany. This paper aims to gain insight into different actors’ perceptions and reflections on the problems and difficulties in the process of self-exclusion to delineate which specific attitudes hamper a successful implementation of SE.

Methods 13 individual and four group interviews with individuals experiencing gambling problems and governmental or commercial gambling providers were examined. A Grounded Theory Approach was used to portray the opinions of these different actors on existing regulations of SE and to delineate potentially diverging interests between the distinct groups.

Results The interviewees agreed on the usefulness of SE and consented that it is important to early recognize individuals experiencing gambling problems. They also considered the present practice insufficient but for different reasons. Individuals experiencing gambling problems and providers particularly disagreed on addressing individuals experiencing gambling problems. While individuals experiencing gambling problems stated that they had hardly ever been approached, providers argued that help offers were mostly rejected. Especially commercial providers also regarded insufficient German language skills and rapid fluctuation of guests as strong barriers to approaching individuals experiencing gambling problems. Interviewees from governmental venues furthermore suspected that commercial providers took addressing individuals experiencing gambling problems less seriously.

Conclusion Our results emphasize the dilemma of conflicting interests in both individuals experiencing gambling problems and providers. Rather than acting against the economic interests of employers, venue staff blame individuals experiencing gambling problems for lack of problem recognition. Conversely, individuals experiencing gambling problems blame the providers for not offering help. To address individuals experiencing gambling problems appropriate staff training is required, and SE regulations need to be controlled by an independent body rather than by the providers themselves.

Härtl, S., Schröder, S., Gartner, C., Wodarz, N. (2023). Beratung Angehöriger pathologischer Glücksspieler/-innen: Status quo und Unterstützungsbedarf: Eine explorative Befragung von Suchthilfe-Mitarbeitenden und Angehörigen zur Entwicklung einer Kurzintervention. Suchttherapie.

Ziel Angehörige von Menschen mit Glücksspielproblemen sind mit gesundheitlichen, sozialen und emotionalen Belastungen konfrontiert. Bis dato existiert jedoch kein etabliertes Konzept zur Unterstützung für diese Zielgruppe. Deshalb sollen in dieser Studie zum einen relevante Rahmenbedingungen und inhaltliche Aspekte der Arbeit mit Angehörigen von Menschen mit Glücksspielproblemen geklärt und zum anderen die Grundlage für die Entwicklung einer Kurzintervention geschaffen werden.

Methodik Onlinegestützte deutschlandweite Befragung von Suchthilfe-Mitarbeitenden (n=102) sowie Gruppendiskussion mit Angehörigen (n=4) im Herbst 2019.

Ergebnisse Die befragten Mitarbeitenden in der Suchthilfe nannten als die wichtigsten Themen für die Beratung von Angehörigen von Menschen mit Glücksspielproblemen das Verhalten Angehöriger gegenüber Betroffenen, Geldmanagement, den Umgang mit Emotionen, Beziehungsberatung und Psychoedukation. Die meisten Befragten gaben an, die Angehörigen im Einzelsetting (68%) in durchschnittlich 3 Sitzungen (Median 2,5; Min=1; Max=15) zu beraten. Der Abstand zwischen den Sitzungen beträgt durchschnittlich 3 Wochen (Median 2 Wochen). Für die zu entwickelnde Kurzintervention wurden Verantwortungsrückgabe und Selbstfürsorge (69%), Problem-/Belastungsexploration (42%) und Tipps zur finanziellen Existenzsicherung (28%) als die drei wichtigsten Themen ausgewählt. Sowohl als Erfolgsfaktor für eine gelingende Angehörigenberatung als auch für die Adhärenz der Angehörigen wurde eine positive bzw. wertschätzende Beziehungsgestaltung am häufigsten genannt. Die Ergebnisse aus der Gruppendiskussion mit Angehörigen deuten in eine ähnliche Richtung: Die Themen Verhalten als Angehörige gegenüber Betroffenen, Abgrenzung/Verantwortlichkeiten und konkrete Verhaltenstipps wurden als wichtig erachtet; jedoch ging es den Angehörigen eher darum, sich „richtig“ zu verhalten, während der Fokus der Suchthilfe auf der Abgrenzung und Selbstfürsorge lag.

Schlussfolgerungen Die Studie liefert wichtige Hinweise auf relevante Themen und Inhalte für die Beratung Angehöriger von Menschen mit Glücksspielproblemen. Auf Basis dieser Ergebnisse soll im nächsten Schritt eine Kurzintervention entwickelt werden. Hinsichtlich der Beratungsmethoden herrscht jedoch weiterer Forschungsbedarf. Zum anderen sollte untersucht werden, wie der Zugang der Angehörigen zum Hilfesystem und dessen Bekanntheit optimiert sowie bestehende Barrieren vermindert werden können.


Sleczka, P., Braun-Michl, B., Schwarzkopf, L., Spörrle, M., & Kraus, L. (2022). Why do they gamble and what does it mean? Latent class analysis of gambling motives among young male gamblers. Addiction Research and Theory, 30(6), 431-440.

Motives to gamble are important in the functional analysis of problematic gambling. This study examines the possibility of classifying young male gamblers based on their motives to gamble and compares the identified groups to validate the obtained classification.

Based on a screening survey among 2,681 young men from Bavaria, n=170 frequent or problem gamblers (Mage= 22.3 years, SD = 2.5) were recruited to participate in a survey with a 2-year follow-up. Latent class analyses (LCA) were conducted based on baseline answers to 10 items measuring five domains of gambling motives: enhancement, coping, self-gratification, and social and financial motives. The identified classes were compared regarding baseline gambling attitudes and impulsiveness as well as gambling behavior and gambling disorder (GD) criteria at baseline and follow-up.

Analyses revealed a four-class solution based on reported motives: ‘primarily fun-motivated gamblers’ (n=100, 58.8%), who gambled mostly for fun; ‘asset and self-gratification seekers’ (n=19, 11.2%) with a high risk of GD at baseline; ‘thrill seekers’ (n=42, 24.7%) with high impulsiveness; and ‘polymotivated coping gamblers’ (n=9, 5.3%) with a higher risk of GD than the ‘primarily fun-motivated gamblers’ in cross-sectional and longitudinal analyses.

The identified group differences support the validity of the classification. ‘Thrill seekers’ and ‘polymotivated coping gamblers’ correspond to the impulsive and emotionally vulnerable pathways described by Blaszczynski and Nower (2002) respectively. The two other groups appear to be subtypes of the behaviorally conditioned type. Motivation-based classification offers a promising approach to identifying individuals with an elevated risk of GD.

Gartner, C., Bickl, A., Härtl, S., Loy, J. K., & Häffner, L. (2022). Differences in problem and pathological gambling: A narrative review considering sex and gender. Journal of Behavioral Addictions, 11(2).

Background and aim
A wide range of studies indicates that men and women with Problem (PrG) and Pathological Gambling (PG) differ in several clinical and sociodemographic characteristics. However, evidence for sex differences, such as the telescoping effect, is contradictory, and it is still unclear whether sex differences observed in offline gambling can also be found for online gambling. Furthermore, reviews have so far focused on binary sex differences but neglect gender aspects. In this study, an updated literature survey of sex- and gender-related differences in PrG and PG was conducted.

We searched PsyInfo, Medline/Pubmed, and the Web of Science databases from 2005 to 2020 for studies investigating sex and gender differences in gambling. A total of 126 papers were included in the literature survey.

We are presenting our findings according to the categories ‘prevalence’ (offline, online, LGBTQI*), ‘sociodemographic factors’, ‘preferred gambling type’, ‘gambling motives’, ‘severity’, ‘progression of gambling problems’, ‘use of professional help/motivation for treatment’, ‘comorbidity’, ‘trauma’, ‘violence and criminality/delinquency’. The studies indicate that, despite some robust sex differences (e.g., concerning prevalence rates), results for most areas were mixed or suggest no sex differences (e.g., violence, gambling motives).

Discussion and conclusion
To date, there is a lack of studies assessing gender, and not only sex, warranting further research in this area.


Kraus, L., Loy, J. K., Bickl, A. M., Schwarzkopf, L., Volberg, R. A., Rolando, S., Kankainen, V. E., Hellman, M., Rossow, I., Room, R., Norman, T., & Cisneros Örnberg, J. (2022). Self-exclusion from gambling: A toothless tiger? [Original Research]. Frontiers in Psychiatry, 13.

While there is evidence for self-exclusion (SE) as an individual-level harm reduction intervention, its effects on reducing harm from gambling at the population level remain unclear. Based on a review of national legal frameworks and SE programs, including their utilization and enforcement in selected high-income societies, the present analysis aims to explore the reach and strengths of SE in the protection of gamblers in these jurisdictions. It places particular emphasis on SE programs' potential to prevent and minimize gambling harm at the population level. The overview examined SE in Finland, Germany, Italy, Massachusetts (USA), Norway, Sweden, and Victoria (Australia). These jurisdictions differ considerably in how gambling is regulated as well as in how SE is implemented and enforced. The reach and extent of enforcement of SE apparently vary with the polity's general policy balance between reducing gambling problems and increasing gambling revenue. But in any case, though SE may benefit individual gamblers and those around them, it does not appear to be capable of significantly reducing gambling harm at the population level. To render SE programs an effective measure that prevents gamblers and those linked to them from financial, social, and psychological harm, utilization needs to be substantially increased by reforming legal regulations and exclusion conditions.


Bickl, A. M., Schwarzkopf, L., Loy, J. K., Grüne, B., Braun-Michl, B., Sleczka, P., Örnberg, J. C., & Kraus, L. (2021). Changes in gambling behaviour and related problems in clients seeking help in outpatient addiction care: Results from a 36-month follow-up study in Bavaria. Journal of Behavioral Addictions, 10(3), 690-700. (Open Access)

Background and aim

Evidence on the course of gambling disorder (GD) in clients seeking help from outpatient addiction care facilities is sparse. To close this knowledge gap, this longitudinal one-armed cohort study portrays the development of GD in help-seeking clients over a 3-year timeframe.


We investigated changes in severity of GD as well as in gambling frequency and intensity in 145 gamblers in outpatient treatment in Bavaria using generalized estimation equations (GEEs). To investigate potentially different trajectories between study participants with and without migration background (MB), additional analyses were applied with time*migration interaction. All analyses were adjusted for age, gender, education, electronic gambling machine (EGM) gambling, MB, GD, related help sought before and treatment status.


Within the entire study population, improvements in severity of GD (reduction of 39.2%), gambling intensity (reduction of 75.6%) and gambling frequency (reduction of 77.0%) were observed between baseline and 36 months of follow-up. The declines were most pronounced between baseline and follow-up 1 and stabilized thereafter. Participants with MB improved consistently less than participants without MB.

Discussion and conclusion

Our study suggests that severity of GD and gambling patterns improve in the context of outpatient treatment. The beneficial results furthermore persist for 36 months after treatment termination. As clients with MB seem to profit less than clients without MB, improvements in outpatient gambling services to the specific needs of this clientele are required.

Schwarzkopf, L., Loy, J. K., Braun-Michl, B., Grune, B., Sleczka, P., & Kraus, L. (2021). Gambling disorder in the context of outpatient counselling and treatment: Background and design of a prospective German cohort study. International Journal of Methods in Psychiatric Research, e1867. (Open Access)

The prospective naturalistic study ‘Katamnese-Studie’ conducted between 2014 and 2019 gathers evidence on the course of gambling disorder in German routine outpatient addiction care. This study elucidates design and methodological advantages and caveats of the study.

Participants of the multi-centre cohort received written questionnaires at admission and at 6-, 12-, 24- and 36-month follow-up to assess socio-demographic data, gambling behaviour, gambling-related consequences and care offers sought. Subsequently, self-reports were linked to client-individual routine documentation for the German Addiction Care Statistical Service. Furthermore, employees of participating outpatient addiction care facilities were surveyed regarding experiences with and attitudes towards gambling disorder. Multivariate longitudinal regression models will portray changes in the severity of gambling disorder and gambling behaviour and explore associated client- and care-related factors.

The ‘Katamnese-Studie’ covers the whole spectrum of outpatient gambling care. Keeping the design-related caveats in mind (reliability of self-reports, loss-to-follow-up and issues regarding causal inference), the study is anticipated to draw a comprehensive picture of routine outpatient gambling care and key factors related to sustained remission. In the medium term, this information might support the development and subpopulation-specific adaptation of recommendations on how to structure process and content of outpatient gambling care.


Sleczka, P., Braun-Michl, B., & Kraus, L. (2020). Gamblers' attitudes towards money and their relationship to gambling disorder among young men. Journal of Behavioral Addictions, accepted manuscript / online first. doi: 10.1556/2006.2020.00042

Sie finden den vollständigen Artikel auf der Webseite der Zeitschrift Journal of Behavioral Addictions (Open Access):

Background and aims Money plays a central role in gambling, and understanding the different attitudes of gamblers towards it might benefit both prevention and treatment of gambling-related problems. This study describes the development of a new German measure of attitudes to money and the differences in these attitudes between male non-gamblers, occasional, frequent and problem gamblers. Furthermore, it investigates the cross-sectional and longitudinal associations between attitudes towards money and the severity of gambling disorder.

Methods An online study was conducted among 2,584 men aged 18–25 years, recruited via the Munich citizen registry. Additionally, a sample of n = 105 Facebook users was included in part of the analyses. Frequent and problem gamblers were invited to a 12-month follow-up. Apart from gambling participation and related problems, the questionnaire included items from existing scales measuring attitudes to money.

Results Three factors underlying a new 12-item German Scale of Money Attitudes (SMAG) were identified: success, budgeting and evil. Compared with other groups, participants reporting any gambling problems scored highest in success and lowest in budgeting. Budgeting was associated with gambling-related problems in both cross-sectional and longitudinal analyses and strengthened the relationship between associating money with success and gambling disorder.

Discussion For problem gamblers, money is important as a personal symbol of success. This attitude has an especially negative effect on gambling-related problems in individuals who handle money irresponsibly. Spending and winning money might play an important role in maintaining self-esteem among gamblers and thus hinder their attempts to quit.

Loy, J., Sedlacek, L., & Kraus, L. (2020). Optimierungsbedarf von Spielersperren. Sucht, 66, 223-235. doi:

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Hintergrund und Fragestellung: Spielersperren stellen eine effektive Maßnahme des Spielerschutzes dar. Sie bedürfen jedoch einer Anpassung an die Bedürfnisse von Personen mit Glücksspielproblemen. Studien weisen auf Defizite hinsichtlich Sperrvorgang und -dauer sowie Zugangskontrollen hin. Ziel der qualitativen Untersuchung war es, Empfehlungen für die Optimierung von Spielersperren abzuleiten.

Methodik: Mit semi-strukturierten Leitfäden wurden die am Prozess einer Spielesperre beteiligten Akteure zu Regelungen der Spielersperre, persönlichen Erfahrungen und Barrieren befragt. Einbezogen wurden Glücksspielende mit und ohne Sperre sowie Angehörige, Fachkräfte, Mitarbeitende von Spielbanken, Spielhallen und der Gesellschaft für Spielerschutz und Prävention (GSP). Insgesamt wurden 20 Einzel- und sechs Gruppeninterviews geführt.

Ergebnisse: Als zentrale Ansatzunkte der Optimierung wurden Sperrdauer und -umfang (übergreifendes Sperrsystem) sowie Zugangskontrollen genannt. Empfohlen wurden eine Antragstellung über Post oder Internet zur Senkung der Hemmschwelle und ein rascheres Inkrafttreten der Spielersperre. Kontrovers diskutiert wurden Sperrdauer und Optionen einer Entsperrung. Durch den Einsatz einer Spielerkarte versprachen sich die Befragten eine Verbesserung des Spielerschutzes durch Feststellung einer laufenden Spielersperre und Begrenzung von Spielzeit oder Geldeinsätzen.

Diskussion: Spielersperren wurden von allen Befragten grundsätzlich positiv bewertet. Optimierungsbedarf wurde in den gesetzlichen Regelungen und Sperrkonditionen gesehen. Von einer Schließung von Gesetzeslücken sowie einer intensiven Aufklärung und Motivation von Glücksspielenden, Angehörigen und Glücksspielanbietern werden positive Effekte auf die Inanspruchnahme von Spielersperren erwartet.

Härtl, S, Sleczka, P, Erbas, B, Buchner, UG (2020). Die Versorgung Angehöriger von Menschen mit Suchtproblemen in Bayern. Explorative Befragung von Mitarbeitenden ambulanter bayerischer Suchthilfeeinrichtungen im Rahmen einer Gelegenheitsstichprobe. Suchttherapie (09. Oktober 2019 efirst), 21(02), 100-108. doi: 10.1055/a-1001-5923.

Sie finden den vollständigen Artikel (kostenpflichtig) auf der Seite der Zeitschrift Suchttherapie (Thieme Verlag):


Ziel Angehörige von Menschen mit Suchtproblemen sind mit gesundheitlichen, sozialen und emotionalen Belastungen konfrontiert. Jedoch liegen für Bayern keine Daten zu ihrer Versorgung im ambulanten Suchthilfesystem vor, weshalb die vorliegende Studie Anhaltspunkte zum Status quo der Angehörigenversorgung in Bayern erhebt. Zudem werden Ressourcen in der Angehörigenarbeit identifiziert und Optimierungspotenziale abgeleitet.

Methodik Onlinegestützte Befragung von Mitarbeitenden der bayerischen Suchtberatungsstellen im September und Oktober 2016 (n=158)

Ergebnisse Primär nahmen Sozialpädagoginnen und Sozialpädagogen an der Befragung teil (78%). Die Angehörigenberatung umfasste in den meisten Einrichtungen (58%) maximal ein Fünftel an allen Beratungen. Am häufigsten wurden die (Ehe-)Partnerinnen und (Ehe-)Partner sowie Eltern von Menschen mit Suchtproblemen beraten. Die beratenen Angehörigen waren meist zwischen 41 und 50 Jahre alt (54%). In den Bereichen Glücksspiel, Computer/Internet und Alkohol wird mehr Angehörigenarbeit relativ zu allen Beratungen geleistet als bei illegalen Drogen/NPS und Medikamenten. Die Belastung der Angehörigen wurde mit einem Mittelwert von 86% auf einer Skala von 0–100% eingeschätzt. Systemische und psychoedukative Konzepte, Ansätze der Co-Abhängigkeit sowie Angehörigengruppen wurden am häufigsten in der Praxis umgesetzt.

Schlussfolgerungen Es besteht Bedarf in Forschung und Versorgung hinsichtlich bisher wenig oder nicht erreichter Gruppen von Angehörigen, bspw. Kindern. Die Definition von Angehörigen als eigene Zielgruppe, die Vernetzung mit anderen Institutionen sowie die Bereitstellung eines praxisrelevanten, evidenzbasierten sowie themen- und zielgruppenspezifischen Fortbildungsangebotes sind hierfür zielführend.


Buchner, U.G., Koytek, A., Wodarz, N., Wolstein, J. (2019). Is an e-mental health programme a viable way to reach affected others of disordered gamblers? A feasibility study focusing on access and retention. International Gambling Studies, (14. September 2018 efirst), doi: 10.1080/14459795.2018.1515974.

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Although affected family members (AFMs) of disordered gamblers suffer from highly stressful living conditions and are in need of specialized help, access to and knowledge of professional support is limited. To improve this situation, an e-mental health programme called EfA with one information module and five consecutive training modules was developed. The study investigated (1) promotion of and referral to EfA, (2) duration of visits and conversion rate, and (3) participants’ characteristics and retention in EfA. In 9 months, 6357 visits were counted. Most visitors arrived at the website via direct access. Those using search terms most commonly used phrases that were used in promotional materials. Per month, 16.1 new potential participants registered. The final sample consisted of 126 participants, most of them female, with high daily Internet usage and low use of prior professional support or self-help. More than one-third finished all modules. This is the first time that data on an e-mental health programme for this clientele was collected in Germany. Findings imply the importance of promoting such a programme in order to reach a clientele that has not had prior help and also show that it is a viable way to reach AFMs.


Motka, F., Grüne, B., Braun, B., & Kraus, L. (2018). Spielersperren in Deutschland: Stand der gesetzlichen Glücksspielregelungen und ihre Umsetzung. Suchttherapie (22. Mai 2018 efirst), doi: 10.1055/a-0583-2888.

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Spielersperren stellen eine Maßnahme des Spielerschutzes dar. Ziel der vorliegenden Arbeit ist die Darstellung der derzeitigen Gesetzesgrundlage von Spielersperren in Deutschland und den Bundesländern und beispielhaft ihrer Nutzung in Bayern. Während auf Basis des Glücksspielstaatsvertrags für das staatliche Glücksspiel eine bundesweite Sperrdatei existiert, werden Spielersperren für das gewerbliche Glücksspiel länderspezifisch organisiert. Aufgrund der uneinheitlichen Gesetzeslage besteht trotz einer ausgesprochenen Spielersperre die Möglichkeit, auf andere Spielformen oder Spielstätten auszuweichen. Diese Gegebenheiten sollten im Beratungs- oder Behandlungskontext aufgegriffen werden, um betroffenen Glücksspielenden eine Abstinenz zu erleichtern. Für eine breite Nutzung von Spielersperren sind strukturelle Veränderungen der derzeitigen Organisation von Spielersperren nötig. Zum einem bedarf es unter Einbeziehung des gewerblichen Glücksspiels einer einheitlichen Regelung mit einer übergreifenden Sperrdatei. Zum anderen könnte über den Abbau von Barrieren und die Einführung transparenter Kriterien für die Entsperrung die Akzeptanz von Spielersperren erhöht werden.

Im Rahmen der Forschungsarbeit der LSG erstellte Kurzberichte sind in den Bereichen

Nutzung der Versorgung

zu finden.



Sleczka, P., Braun, B., Grüne, B., Bühringer, G., & Kraus, L. (2017). Family functioning and gambling problems in young adulthood: the role of the concordance of values. Addiction Research and Theory, published online 21 nov, doi: 10.1080/16066359.2017.1393531.

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Background: Although young adult men are at an elevated risk for gambling problems (GP), compared to adolescents and adults in general this group is still largely unresearched. The current study investigates whether family functioning, which is associated with reduced risk for GP in adolescence, also affects gambling in young adults, who are more independent than minors. It analyses the relationship between GP and two core components of family functioning, the effectiveness of problem-solving in the family and perceived concordance of values. Methods: Data came from the baseline, 12- and 24-month follow-up assessments of Munich Leisure-time Study (MLS), a longitudinal online study in young male gamblers. Young men were recruited via the Munich citizens' registry (n=2,693) and Facebook invites (n=105). In total, n=173 individuals positively screened for frequent and/or regular gambling participated in the study. The hypothesised relations between problem-solving, concordance of values and GP were investigated with a path model controlling for non-planning impulsiveness and psychological distress. Results: Higher concordance of family values was significantly related to less GP in cross-sectional and longitudinal analyses. It mediated the relation between the effectiveness of problem-solving and GP. Conclusions: While previous studies indicated good family functioning as a factor preventive of GP, the current results indicate that this association is mediated by the perceived concordance of family values. In families with effective problem-solving, common family values might facilitate recognition of and reaction to first signs of problems. Perceived discordance may lead to feelings of shame and concealment of GP.


Kiraly, O., Sleczka, P., Pontes, H. M., Urban, R., Griffiths, M. D., & Demetrovics, Z. (2017). Validation of the Ten-Item Internet Gaming Disorder Test (IGDT-10) and evaluation of the nine DSM-5 Internet Gaming Disorder criteria. Addictive Behaviors, 64, 253-260. doi: 10.1016/j.addbeh.2015.11.005.

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INTRODUCTION: The inclusion of Internet Gaming Disorder (IGD) in the DSM-5 (Section 3) has given rise to much scholarly debate regarding the proposed criteria and their operationalization. The present study's aim was threefold: to (i) develop and validate a brief psychometric instrument (Ten-Item Internet Gaming Disorder Test; IGDT-10) to assess IGD using definitions suggested in DSM-5, (ii) contribute to ongoing debate regards the usefulness and validity of each of the nine IGD criteria (using Item Response Theory [IRT]), and (iii) investigate the cut-off threshold suggested in the DSM-5.

METHODS: An online gamer sample of 4887 gamers (age range 14-64years, mean age 22.2 years [SD=6.4], 92.5% male) was collected through Facebook and a gaming-related website with the cooperation of a popular Hungarian gaming magazine. A shopping voucher of approx. 300 Euros was drawn between participants to boost participation (i.e., lottery incentive). Confirmatory factor analysis and a structural regression model were used to test the psychometric properties of the IGDT-10 and IRT analysis was conducted to test the measurement performance of the nine IGD criteria. Finally, Latent Class Analysis along with sensitivity and specificity analysis were used to investigate the cut-off threshold proposed in the DSM-5.

RESULTS: Analysis supported IGDT-10's validity, reliability, and suitability to be used in future research. Findings of the IRT analysis suggest IGD is manifested through a different set of symptoms depending on the level of severity of the disorder. More specifically, "continuation", "preoccupation", "negative consequences" and "escape" were associated with lower severity of IGD, while "tolerance", "loss of control", "giving up other activities" and "deception" criteria were associated with more severe levels. "Preoccupation" and "escape" provided very little information to the estimation IGD severity. Finally, the DSM-5 suggested threshold appeared to be supported by our statistical analyses.

CONCLUSIONS: IGDT-10 is a valid and reliable instrument to assess IGD as proposed in the DSM-5. Apparently the nine criteria do not explain IGD in the same way, suggesting that additional studies are needed to assess the characteristics and intricacies of each criterion and how they account to explain IGD.


Buchner, U.G., Koytek, A., Wodarz, N., Wolstein, J. (2017). Hilfe aus dem Netz für Angehörige von Menschen mit gestörtem Glücksspielverhalten –Nutzung und Ergebnisse des E-Mental-Health-Programms EfA. Suchttherapie (16. November 2017 efirst), doi: 10.1055/s-0043-119332.

Sie finden den vollständigen Artikel auf der Seite der Zeitschrift Suchttherapie (Thieme Verlag):

Ziel Angehörige von Personen mit einer Störung durch Glücksspielen sind häufig durch Stress belastet; viele benötigen Unterstützung. Daher wurde mit „Verspiel nicht mein Leben“ – Entlastung für Angehörige (EfA) ein webbasiertes Angebot entwickelt. Berichtet werden Teilnehmenden-Charakteristika, ihre Lebenssituation, belastende Themen, Hilfesuchverhalten, Selbstwirksamkeitserwartung und Beanspruchung.

Methodik Onlinegestützte Befragung der Teilnehmenden von Juni 2013 bis Juni 2016, u.a. KPD-38 und SQFM-AA.

Ergebnisse Primär nahmen Frauen teil (89,1%). Die meisten Teilnehmenden waren Partner/innen (68,2%). Das Belastungserleben war erhöht, dennoch hatten zwei Drittel bislang keine Hilfen genutzt. Durch die Teilnahme an EfA konnte das Selbstwirksamkeitserleben verbessert und die allgemeine Lebenszufriedenheit gesteigert werden.

Schlussfolgerungen EfA ist ein niedrigschwelliges Angebot, das Angehörigen den Einstieg in professionelle Hilfen ermöglicht und ihnen erste Hilfen gibt.



Sleczka, P., Braun, B., Grüne, B., Bühringer, G., & Kraus, L. (2016). Proactive coping and gambling disorder among young men. Journal of Behavioral Addictions, 5 (4), 639-648. doi: 10.1556/2006.5.2016.080.

Open Access

Objectives Male sex, young age, and frequent gambling are considered as risk factors for gambling disorder (GD) and stress might be one of the triggers of gambling behavior among problem gamblers. Conversely, well-developed coping with stress might counteract gambling problems. The Proactive Coping Theory provides a promising approach for the further development of preventive and treatment measures. The objective of the study was to investigate different facets of proactive coping (PC) in young male gamblers.

Methods Young men from Bavaria were recruited via the Munich citizens’ registry (n?=?2,588) and Facebook invitations (n?=?105). In total, 173 out of 398 individuals were positively screened for frequent gambling and/or signs of related problems and completed the baseline questionnaire of the Munich Leisure-time Study. Factors investigated include gambling problems, PC, impulsiveness, social support, and psychological distress.

Results Gambling problems were associated with lower levels of preventive coping as well as of adaptive reaction delay. The associations were also significant when controlled for impulsiveness and general psychological distress. Preventive coping moderated the association between social support and gambling problems.

Discussion and conclusions Young men with gambling problems less frequently prevent the occurrence of stressors and more often react hasty when these occur. While the investigated group reported good social support, this factor was negatively associated with GD only among individuals with good preventive coping. Preventive coping poses a useful construct for selective prevention and treatment as it can be modified in professional interventions.

Buchner, U.B., Koytek, A., Fischer, U.C., Wodarz, N., Wolstein, J. (2016). Psychometrische Evaluation des deutschen Kurzfragebogens für suchtbelastete Familienmitglieder SQFM-AA (Version Glücksspiel). Psychotherapie, Psychosomatik, Medizinische Psychologie Psych Med 66: 155-162, doi: 10.1055/s-0042-100812.

Sie finden den vollständigen Artikel auf der Seite der Zeitschrift Psychotherapie, Psychosomatik, Medizinische Psychologie (Thieme Verlag):

: Angehörige von Personen mit einer Störung durch Glücksspielen sind durch die Erkrankung häufig stark belastet. Bislang gibt es allerdings im deutschen Sprachraum kein Instrument, um diese Belastung adäquat zu erfassen. International wird der Short Questionnaire for Family Members – affected by addiction (SQFM-AA) genutzt, der auf dem Stress-Strain-Coping-Support-Modell aufbaut. Daher wird dieser Fragebogen als Kurzfragebogen für suchtbelastete Familienmitglieder SQFM-AA (Version Glücksspiel) adaptiert und getestet, um die Belastung Angehöriger erfassen zu können und internationale Vergleichbarkeit zu gewährleisten.

Methoden: Nach der Übersetzung und Rückübersetzung des Fragebogens wurde dieser einer Gelegenheitsstichprobe im Online-Setting vorgelegt. Es wurden zentrale deskriptive und psychometrische Kennwerte, Trennschärfe und interne Konsistenz berechnet. Die Faktorenstruktur wurde anhand einer explorativen Faktorenanalyse (Hauptachsenanalyse mit Varimax-Rotation) erhoben.

Ergebnisse: Die Daten von 122 betroffenen Angehörigen (87% weiblich; 67% Partner/-innen; 61% gemeinsamer Haushalt) gingen in die Auswertung ein. Die Trennschärfe liegt zwischen 0,30–0,94, Cronbachs Alpha bei 0,61–0,95. In der Faktorenanalyse werden durch eine 9-Faktoren-Lösung 69% der Varianz aufgeklärt.

Diskussion: Aufgrund des Vorgehens bei der Übersetzung kann von einer guten Vergleichbarkeit der deutschen Version mit dem Original ausgegangen werden. Die interne Konsistenz der einzelnen Skalen liegt in einem akzeptablen bis guten Bereich. Die ursprünglich 11 Unterskalen des SQFM-AA lassen sich in unserer Stichprobe nicht reproduzieren. Die aufgedeckten 9 Faktoren sind jedoch gut aus den theoretischen Vorüberlegungen ableitbar. 4 der Skalen bilden sich sehr gut ab, auf 3 weiteren Faktoren finden sich relevante Nebenladungen anderer Skalen. Bei den beiden verbleibenden Skalen lädt zudem eines der Items nicht auf den entsprechenden Faktor. Insgesamt lassen sich die Faktoren inhaltlich gut interpretieren. Durch eine Modifikation des Fragebogens ließen sich zwar einzelne Kennwerte verbessern, allerdings wäre dann eine internationale Vergleichbarkeit nicht mehr gegeben.

Schlussfolgerung: Mit der hier vorliegenden Adaptation lassen sich erstmalig die Erfahrungen von Angehörigen von Personen mit einer Störung durch Glücksspielen einheitlich erfassen und relevante Bereiche für Therapie und Beratung identifizieren.

Buchner, U. G., Koytek, A., Wodarz, N., Wolstein, J. (2016). SQFM-AA. Kurzfragebogen für suchtbelastete Familienmitglieder (Version Glücksspiel). In: Leibniz-Zentrum für Psychologische Information und Dokumentation (ZPID) (Hrsg.), Elektronisches Testarchiv (PSYNDEX Tests-Nr. 9007042). Trier: ZPID.


Buchner, U., Erbas, B., Stürmer, M., Arnold, M., Wodarz, N., & Wostein, NJ. (2015). Inpatient treatment for pathological gamblers in Germany: setting, utilization, and structure. Journal of Gambling Studies, 31 (1), 257-279.

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In Germany, there are two different approaches to inpatient treatment of pathological gambling (PG): Facilities focusing on addiction or on psychosomatic illness. However, little is known about how these differences influence utilization and structure of treatment. Therefore, in our study, we analyzed all known German gambling inpatient treatment centers concerning patients’ sex, age and number of comorbid disorders and evaluated an expert assessment of the treatment system, access to treatment, and structure characteristics of inpatient treatment facilities. In 2011, 2,229 pathological gamblers were treated. This amounts to 1 % of all past-year pathological gamblers. 90 % of the patients were men, 93 % had at least one comorbid disorder. Access to treatment was mostly gained via psychosocial counseling centers, but was not readily available. Facilities with addiction departments treated less pathological gamblers per year (29.3 gamblers) than facilities with psychosomatic departments (53.3 gamblers) or with both departments (76.4 gamblers). Treatment duration was significantly longer in addiction departments treating PG as secondary diagnosis only, with a low rate of gamblers on all patients, or treating few gamblers. Some facilities specialized on PG and treated more gamblers, had a higher rate of gamblers on all patients, and offered specific treatment programs. The impact of this specialization on treatment outcome is still unclear. Although treatment numbers have risen steadily for the past years, only a small fraction of affected gamblers seek inpatient treatment. Therefore, awareness to the disease and access to treatment needs to be improved.

Sleczka, P., Braun, B., Bühringer, G. & Kraus, L. (2015). DSM-5 criteria for gambling disorder: underlying structure and applicability to specific groups of gamblers. Journal of Behavioral Addictions 4(4), 226–235

Open Access:

Background and Aims DSM-5 provides nine diagnostic criteria for gambling disorder. All criteria have pre-assumed equal impact on the diagnosis and are applied to all individuals and groups of disordered gamblers in an equal manner. The aims of the study are to analyse the structure underlying the diagnosis and to assess whether DSM-5 is equally applicable to different groups of gamblers.

Design and setting Data from the 2009 German Epidemiological Survey of Substance Abuse and from a study on slot machine gamblers were used. Item Response Theory analyses were applied to estimate discrimination and severity parameters of the diagnostic criteria. With the use of Differential Item Functioning analyses, potential criterion biases were analysed.

Participants and measurement We analysed data from 107 participants from the general population sample and 476 participants from the slot machines gamblers sample who answered a 19-items diagnostic questionnaire based on the DSM-5 criteria for gambling disorder.

Findings A single underlying factor, the severity of gambling disorder, was identified. The criteria of preoccupation and chasing were least severe and showed low discriminatory power. Bailout, withdrawal and jeopardized matters criteria had highest severity and discriminatory power. The comparison of the two samples revealed two criterion biases in the preoccupation and tolerance criteria.

Conclusions The structure underlying the criteria is unidimensional but the disorder is manifested differently depending on disorders severity. The assumed equal impact of each criterion lacks support in the findings. The DSM-5 criteria measure in slot machine gamblers partially different construct than in gamblers in general.

Keywords gambling disorder, DSM-5, IRT, criterion bias,


Künzel, J., Brand, H., & Braun, B. (2015). Klienten/Patienten mit HD pathologisches Glücksspielen in ambulanter und stationärer Suchtbehandlung (Kurzbericht Nr. 1/2015 - Deutsche Suchthilfestatistik 2013). München: IFT Institut für Therapieforschung.




Braun, B., Kräplin, A., & Bühringer, G. (2014).  Verhaltensprävention von pathologischem Glücksspielen. (Buchkapitel). In: Mann, K. (Hrsg.): Verhaltenssüchte: Grundlage, Diagnostik, Therapie, Prävention. Springer Verlag: Berlin

Nach einer Übersicht über personenbezogene Korrelate und Risikofaktoren für pathologisches Glücksspielen (PG) werden universelle, selektive und indizierte verhaltenspräventive Maßnahmen anhand aktueller Überblicksarbeiten vorgestellt. Ein weiterer Schwerpunkt ist die Frage nach der Verbesserung der derzeit geringen Erreichbarkeit von Glücksspielern, die erste Anzeichen einer beginnenden Störung zeigen. Weiterhin erfolgt eine Darstellung der in der Literatur empfohlenen Leitlinien für Präventionsstrategien. Aufgrund des hohen Anteils von Glücksspielern (etwa 45%) und des geringen Anteils von Personen mit PG (etwa 0,3%) in der Bevölkerung werden als Schwerpunkt selektive und indizierte Präventionsmaßnahmen empfohlen. Abschließend wird u.a. diskutiert, wie und in welcher Abfolge verhaltens- und verhältnispräventive Maßnahmen sinnvoll kombiniert werden könnten.

Braun, B., Ludwig, M., Sleczka, P., Bühringer, G. & Kraus, L. (2014). Gamblers seeking treatment: Who does and who doesn´t? Journal of Behavioral Addictions, 3 (3), 189-198


Background and aims: As only a minority of pathological gamblers (PGr) presents for treatment, further knowledge about help-seeking behavior is required in order to enhance treatment utilization. The present study investigated factors associated with treatment participation in gamblers in Germany. As subclinical pathological gamblers (SPGr, fulfilling one to four DSM-IV-criteria) are target of early intervention due to high risk of transition to pathological gambling, they were subject of special interest. Methods: The study analyzed data from a general population survey (n = 234, SPGr: n = 198, PGr: n = 36) and a treatment study (n = 329, SPGr: n = 22, PGr: n = 307). A two-step weighting procedure was applied to ensure comparability of samples. Investigated factors included socio-demographic variables, gambling behavior, symptoms of pathological gambling and substance use. Results: In PGr, regular employment and non-German nationality were positively associated with being in treatment while gambling on the Internet and gaming machines and fulfilling more DSM-IV-criteria lowered the odds. In SPGr, treatment attendance was negatively associated with married status and alcohol consumption and positively associated with older age, higher stakes, more fulfilled DSM-IV criteria and regular smoking. Conclusions: In accordance to expectations more severe gambling problems and higher problem awareness and/or external pressure might facilitate treatment entry. There are groups with lower chances of being in treatment: women, ethnic minorities, and SPGr. We propose target group specific offers, use of Internet-based methods as possible adaptions and/or extensions of treatment offers that could enhance treatment attendance.

Open Access

Bühringer, G. (2014). Addiction research centres and the nurturing of creativity - IFT Institut für Therapieforschung in Munich, Germany. Addiction, 109 (8), 1245-1251.

This paper describes the history and current structure of the Institut für Therapieforschung (IFT) [Institute for Therapy Research] in Munich, as well as major research topics and factors which might contribute to a creative structure and atmosphere for innovative research in the addiction field. The institute was founded in 1973 as a non-profit nongovernmental organization (NGO) with a focus on applied research. Starting with behaviour therapy-based development
and evaluation of programmes for alcohol, illicit drugs and smoking and the evaluation of treatment services, the institute gradually expanded its topics, covering prevention (1985) and epidemiology and policy evaluation (1990),
and participated throughout this period in the development of guidelines and screening, diagnostic and clinical instruments. Later, the IFT tried to bridge the gap between basic sciences, applied research, health-care services and
health policy, with a network of national and international contacts, including its own university engagements and collaborations with foreign research groups and national and European Union (EU) agencies. Possible creativitypromoting
factors on the institutional and individual levels are discussed, e.g. the  collaboration of experienced senior researchers with carefully selected innovative doctoral students, considerable in-house and external training of young researchers and the early participation and presentation of theirwork at international conferences, independence from stakeholders in the field and the refusal of project funds which require external clearance of publications.


Forberger, S. & Bühringer, G. (2014). Governance regulations of the gambling market: Between nanny state and laissez faire? In P. Anderson, G. Bühringer & J. Colom (Eds.), Refraiming addiction: Policies, processes and pressures. The Alice-Rap project (pp. 58-73).

Background: Gambling in Europe is highly regulated, with considerable differences between EU member states. Regulations and policies in the gambling market are influenced by interactions between national gambling regulations, European jurisdictions, and case law. They are based on different aims, e.g. (1) to pursue public health interests like preventing gambling disorders, consumer protection and protection of disordered gamblers, as well as, (2) to promote economic interests like tax revenues, market shares and company profits. Aims: We aim to analyse possible justifications for regulations in the gambling market. Methods: We analyses Mill’s harm principle as an individual-based public health approach and the economic theory of failed markets as an example of a liberal approach. Results: Both examples of these opposing concepts would justify governmental interventions in the gambling market under certain specific conditions. The major, common reason for market regulation is seen in avoiding harms to others. Regulations might be justified in the cases of avoiding risk to others and to those incapable and to prevent failed markets. Conclusions: Underlying justifications are based on different political and philosophical concepts and lead to different solutions to strike a balance between individual freedom and governmental control. These different options, related benefits and harms, require consideration in a broader public debate and further research to lead to improved policies and regulations within the EU.


Anderson, P., Bühringer, G. & Colom, J. (2014). Alice rap essays in addiction governance. In P. Anderson, G. Bühringer & J. Colom (Eds.), Refraiming addiction: Policies, processes and pressures. The Alice-Rap project (pp. 5-7). ISBN: 978-84-697-1647-2:


Rehm, J., Probst, C., Kraus, L. & Lev-Ran, L. (2014). The addiction concept revisited. In P. Anderson, G. Bühringer & J. Colom (Eds.), Refraiming addiction: Policies, processes and pressures. The Alice-Rap project (pp. 102-116). ISBN: 978-84-697-1647-2: