Papers by Sophie Vasiliadis
Motivations and volition underlying youth at-risk gambling: the application of the Health Action Process Approach model
© 2015 Dr. Sophia Despina VasiliadisMany young adults in developed countries have grown up in an ... more © 2015 Dr. Sophia Despina VasiliadisMany young adults in developed countries have grown up in an environment greater accessibility and diversity of gambling products. Despite the evidence of substantial vulnerability, youth gambling research has trailed behind research with adults. This research has generally been conducted without the context of a theoretical framework, limiting the ability to provide meaningful context to evidence. The primary aim of this study was to explore the utility of the Health Action Process Approach (HAPA) model in explaining gambling involvement and problem gambling among young adults. The distinguishing proposition of this behaviour model is that intention indirectly predicts behaviour through action planning and strategies for overcoming barriers to the behaviour. The study also aimed to explore how the addition of gambling motivations could significantly contribute to the HAPA model. In order to examine motivations in this way, the study also tested the Motivation Model’s assertion that motivations are proximal predictors of behaviour, beyond co-occurring issues such as substance use and impulsivity. This study took a novel approach in two key respects: a) the first application of the HAPA model to a health compromising behaviour (i.e. gambling) on the premise that similar factors underlie both health promoting and compromising behaviours, and b) the examination of gambling involvement (and problem gambling severity), on which there was comparatively little evidence or theoretical modelling at the time this study was conducted. A sample 823 young adults (18 to 25 year olds) in Victoria, Australia, completed an online survey. Participants were primarily students from five universities and technical and further education (TAFE) institutions. The sample showed similar socio-demographic diversity to the population of young adults in Victoria. The HAPA model showed adequate utility in explaining gambling involvement and problem gambling severity. This indicated that motivation and volition factors are important in gambling, with intention being secondary to knowledge of, and accessibility to gambling products, and a means to continue gambling. Some support was demonstrated for the inclusion of gambling motivation factors in the HAPA model. A strong, direct relationship between gambling problem severity and emotion regulation motivations was observed. Different outcomes observed for gambling involvement and problem gambling severity indicated that these are related, but different constructs. Weaker associations found with gambling involvement indicated limitations in measurement. More research is required to develop a valid and reliable measure of involvement. Support for the HAPA model indicated that strict regulation of gambling product accessibility could be an effective early intervention approach. This finding also suggests that similar factors underlie health promoting and compromising behaviours. Further research into the broader utility of the HAPA model is warranted. Signs of gambling for emotion regulation, e.g. for a thrill or escape, should be included in education campaigns in schools and across media platforms, and should be addressed by professionals working with youth in assessment, referral, and treatment plans. Further research in this area is required to develop a better understanding of the role of these factors in the development of gambling problems, and success in recovery
Journeys through gambling: pathways to informal recovery
This study aimed to investigate the temporal benchmarks in informal gambling recovery pathways, w... more This study aimed to investigate the temporal benchmarks in informal gambling recovery pathways, with attention to the broader context of the experience for individuals, and to the experiences of young adults. While problem gambling counselling services are available and promoted, only a small proportion of those who experience gambling-related issues choose to resolve their problems with professional support. Rather, people attempt to recover through self-managed means such as self-help strategies and family support. Further, despite their increased vulnerability to gambling problems, young adults are greatly under-represented in treatment services, suggesting that young adults are even more likely to use informal means of recovery from problem gambling than older people. The majority of gambling recovery-related research to date has focused on formal treatment services and support programs such as Gambler’s Anonymous, which are most likely to be accessed by people with long-term, severe gambling problems. Gaps remain in the understanding of contextual factors throughout the process, and how they interact with changing self-awareness, and strategies to support recovery. This is particularly so in the case of young adults, whose experiences and expression of gambling recovery may differ from those of older adults given developmental differences and differences in the ways that young adults engage with gambling products. Narrative interviews with 32 young and older adults were conducted to develop an understanding of the motivations and experiences of informal recovery, and the social, environmental and temporal context of informal recovery. Narratives were analysed as a single unit, and attention was paid to any emerging differences in patterns for younger and older adults. Narrative analysis informed three key benchmarks in recovery: recognition of a problem; the impetus to initiate a recovery process; and the strategies used by participants to assist recovery. Differential patterns emerged in the ways that participants experienced these benchmarks but, interestingly, a key finding was in whether the recovering gambler was the agent in recovery, or whether they were compelled by someone or an event. In problem recognition, analysis defined (a) a self-recognised pathway, where the participant was positioned as agent in recognising their own problems, and (b) an externally recognised pathway, where the participant only actively recognised their problem after confrontation from someone close to them (e.g. a family member, friend or employer) or a significant negative event (e.g. hitting rock bottom). Similarly, analysis around the impetus for initiating the recovery process identified differences according to whether the participant was (a) the primary agent in recovery initiation and management to achieve personal goals and life-stage milestones that gambling had delayed (“selfdirected” pathway), or (b) had the recovery process imposed upon them by others who had been affected by their gambling, or a significant negative event (“externally directed” pathway). Regarding strategies used by individuals to resolve problems, the primary contribution of the current study was the identification of differential patterns in strategy management according to the individual's centrality of agency in recovery. The analysis revealed that recovery processes for younger and older participants were more similar than different, however some subtle differences emerged. In comparison to older participants, many young adults tended to have a strong sense of agency in recovery. While young adult participants described their gambling problem as an addiction, they also derived empowerment from a moment of clarity during an urge to gamble, where they felt they could make a decision not to gamble. This sense of empowerment motivated them throughout the recovery process. For many young adult participants, the process and outcome of successful recovery was defined by the prioritisation and pursuit of prosocial and conventional milestones for their age, such as maintaining a long-term romantic relationship, purchasing a home, travelling overseas, or career advancement. Importantly, the study found that delays in recognition of a gambling problem could relate to responses from significant others around the gambler, including the enabling effect of budgeting for gambling within household expenses and the normalisation of gambling and associated harms through others’ gambling. Additionally, the study found that workplaces can play an important role in supporting recovery through informal strategies as well as employer assistance programs. The strong moderating effect of personal, social, financial, and cultural resources on the process of recovery was highlighted, and articulated in terms of how they may impact on the experiences of each of the pathways. In light of these findings, the recovery capital construct that has been…
Health & Social Care in the Community, 2020
This study investigated the expectations of older people who chose to participate in a self-manag... more This study investigated the expectations of older people who chose to participate in a self-management trial of home aged care packages conducted by COTA Australia. Empowerment theory is used to interpret the findings. All Australian home aged care support packages are delivered using a consumer directed care (CDC) model, and most are managed by an aged care provider. The COTA Australia trial gave older KEYWORDS Consumer directed care (CDC), Empowerment, Informal Carers, Risk, Self-directed support, User Choice and Participation All Australian home aged care packages have been delivered on a 'consumer directed care' (CDC) basis
The Role of Expectancies and Motivations in Young Adult Problem Gambling
Journal of Gambling Issues, 2013
This paper presents the findings of a systematic search undertaken for the period January 1990 to... more This paper presents the findings of a systematic search undertaken for the period January 1990 to June 2011 of references including original, empirical findings of the relationship between accessibility of electronic gaming machines and rates of gambling involvement, problem gambling, or gambling-related treatment seeking. Titles and abstracts of 2156 references were reviewed, yielding 39 references meeting inclusion criteria. The review has revealed that the relationships between the physical accessibility dimensions of proximity and density and gambling involvement and problem gambling are complex. Research is only beginning to elucidate these dimensions, and many questions and methodological challenges remain to be addressed. The strengths, limitations, and gaps in the literature are discussed, and recommendations are made for future research. Cet article présente les résultats d'une recherche documentaire systématique, effectuée entre janvier 1990 et juin 2011, incluant des ...
Melbourne: Gambling …
for literature review (Chapters 2 and 3) preparation; data analytic strategy; data analysis, repo... more for literature review (Chapters 2 and 3) preparation; data analytic strategy; data analysis, reporting, and interpretation; data collection for Studies 3 and 4; project design; and manuscript preparation and review. Alun Jackson, Professor and Director, Problem Gambling Research and Treatment centre, University of Melbourne. Chief Investigator responsible for overall project management; data collection for Studies 2 and 3; guidelines (Chapter 10) preparation; project design; and manuscript preparation.
Addictive Behaviors, 2016
International Journal of Mental Health and Addiction, 2017
This study applied a holistic, strength-based lens to better articulate the impetus for, and proc... more This study applied a holistic, strength-based lens to better articulate the impetus for, and processes of, informal recovery from gambling problems. Two research objectives framed the parameters of the study: to explore (a) the process by which gamblers move from recognition of a gambling problem to action for recovery and (b) the experiences, perceptions and contextual factors that shape the features of this process. Narrative telephone interviews were conducted with adult residents of Victoria, Australia. Thirty-two adult participants (22 males and 10 females) were recruited from the general community. All participants were selfidentified as recovering or recovered from gambling problems. Participants primarily used informal recovery strategies, rather than professional services or support groups. The impetus for informal recovery was identified broadly as either (a) dissonance between desired and actual self-image and goals, (b) an uncontrollable adverse event, or (c) confrontation and decisive action by others affected by the individual's gambling involvement. The impetus, process and goals of recovery were best described by pathways that were distinguished by agency in recovery: externally directed and self-directed. The application of a strength-based lens helped to illuminate the role of agency in informal recovery. A proposed pathways framework may inform strength-based informal recovery strategies for gamblers and affected others, and therapeutic approaches. The pathways, which have not been articulated in previous gambling recovery literature, generally cohere with pathways articulated in the alcohol and substance recovery literature.
Self‐managed aged home care in Australia – Insights from older people, family carers and service providers
Health & Social Care in the Community
This paper presents findings from the evaluation of an Australian trial of self-managed home aged... more This paper presents findings from the evaluation of an Australian trial of self-managed home aged care. The self-management model was codesigned by advocacy organisation COTA Australia, consumers and service providers. The primary aim of the evaluation was to examine whether self-management improved consumers' perceptions of their choice, control, and wellbeing. The secondary aim was to examine whether provider prior experience with self-managed packages significantly influenced consumers' perceptions of choice, control and wellbeing, thereby confounded trial effects. A pre-test post-test quasi-experimental design and mixed-methods design were used to collect data over nine months in 2018-2019. The pre-trial methods and findings have been published. The post-trial evaluation replicated the pre-trial data collection method of an
Health and Social Care in the Community, 2021
This paper presents findings from the evaluation of an Australian trial of self-managed home aged... more This paper presents findings from the evaluation of an Australian trial of self-managed home aged care. The self-management model was codesigned by advocacy organisation COTA Australia, consumers and service providers. The primary aim of the evaluation was to examine whether self-management improved consumers' perceptions of their choice, control, and wellbeing. The secondary aim was to examine whether provider prior experience with self-managed packages significantly influenced consumers' perceptions of choice, control and wellbeing, thereby confounded trial effects. A pre-test post-test quasi-experimental design and mixed-methods design were used to collect data over nine months in 2018-2019. The pre-trial methods and findings have been published. The post-trial evaluation replicated the pre-trial data collection method of an
Service access and coordination in co-morbid pathological gambling cases: A proof of concept study
Clinical practice and empirical research has demonstrated that problem gamblers who present for t... more Clinical practice and empirical research has demonstrated that problem gamblers who present for treatment are often complex cases with multiple diagnoses. The current project utilised a service mapping approach to investigate mental health service use by clients of a problem gambling treatment service. Twenty one clients (9 male) from Gambler's Help services in a regional/ rural area of Victoria, Australia were interviewed. Results indicated that a majority of people had been in contact with a General Practitioner or mental health services but had not disclosed their gambling problem. Although clients generally had long 'careers' as problematic gamblers and were clients of multiple services, none had been screened for problem gambling. The current study indicates the need for screening for problem gambling and protocols for case management between problem gambling counselling services and mental health services.
Australian gambling research priorities: summary findings from consultations conducted by the Australian Gambling Research Centre
This paper on gambling research priorities is intended to assist researchers and policy makers to... more This paper on gambling research priorities is intended to assist researchers and policy makers to develop research focused on improving the short- and long-term health and wellbeing of Australians who gamble and who are affected by gambling. Overview The Australian Gambling Research Centre (AGRC) conducted consultations with individuals and groups in the gambling sector in 2013-14. The priority areas helped inform the development of the research directions for the AGRC as well as priorities for knowledge translation and exchange. They should also assist researchers and policy makers to develop research focused on improving the short- and long-term health and wellbeing of Australians who gamble and who are affected by gambling. The national research priorities are to: understand gambling harm more broadly; determine ways to reduce or minimise harm from gambling; understand the ways in which community and gambling environments influence gambling; explore how new and emerging technolog...
Communication needs and the Australian gambling field
Effective frameworks for communication can bridge gaps between research, clinical practice, and p... more Effective frameworks for communication can bridge gaps between research, clinical practice, and policy. The gambling sector in Australia comprises a number of stakeholder groups with diverse interests, objectives, and professional skills and resources. The diversity of the sector can present challenges in developing communication strategies that are accessible, and adequately meet the needs of the audience. This report provides insight into ways in which these challenges may be addressed. In 2013-14 the Australian Gambling Research Centre (AGRC) interviewed and surveyed government officials, service providers, researchers, and community and industry representatives involved in the gambling sector to identify their principal information and resource needs. The findings informed the development of the AGRC's research communication plan. The key findings are: professionals often find it difficult to access important resources; summaries and key messages of longer documents are valu...
Motivation is the Message. The Gambling Motivations Questionnaire (GMQ) and Young Adults
Consumer expectations of self-managing aged home care packages in Australia in Health and Social Care in the Community
Australia in Health and Social Care in the Community, 2020
• There was a significant relationship between parent-and-offspring problem gambling. • This rela... more • There was a significant relationship between parent-and-offspring problem gambling. • This relationship persisted after accounting for sociodemographic characteristics. • Self-enhancement and money expectancies mediated intergenerational transmission. • Over-involvement and emotional impact expectancies mediated intergenerational transmission. • Enhancement and coping motives mediated intergenerational transmission. Introduction: The risk for developing a gambling problem is greater among offspring who have a problem gambling parent, yet little research has directly examined the mechanisms by which this transmission of problem gambling occurs. For this reason, the present study sought to examine the degree to which children's ex-pectancies and motives relating to gambling explain, at least in part, the intergenerational transmission of problem gambling. Methods: Participants (N = 524; 56.5% male) were recruited from educational institutions, and retrospectively reported on parental problem gambling. Problem gambling was measured using the Problem Gambling Severity Index and a range of positive and negative expectancies and gambling motives were explored as potential mediators of the relationship between parent-and-participant problem gambling. Results: The relationship between parent-and-participant problem gambling was significant, and remained so after controlling for sociodemographic factors and administration method. Significant mediators of this relationship included self-enhancement expectancies (feeling in control), money expectancies (financial gain), over-involvement (preoccupation with gambling) and emotional impact expectancies (guilt, shame, and loss), as well as enhancement motives (gambling to increase positive feelings) and coping motives (gambling to reduce or avoid negative emotions). All mediators remained significant when entered into the same model. Conclusions: The findings highlight that gambling expectancies and motives present unique pathways to the development of problem gambling in the offspring of problem gambling parents, and suggest that gambling cognitions may be potential candidates for targeted interventions for the offspring of problem gamblers.
This paper on gambling research priorities is intended to assist researchers and policy makers to... more This paper on gambling research priorities is intended to assist researchers and policy makers to develop research focused on improving the short- and long-term health and wellbeing of Australians who gamble and who are affected by gambling.
The gambling sector in Australia comprises a number of stakeholder groups with diverse interests,... more The gambling sector in Australia comprises a number of stakeholder groups with diverse interests, objectives, and professional skills and resources.
In 2013-14 the Australian Gambling Research Centre (AGRC) interviewed and surveyed government officials, service providers, researchers, and community and industry representatives involved in the gambling sector to identify their principal information and resource needs. The findings informed the development of the AGRC's research communication plan.
Organisations may use the findings of this summary to inform practices around information and resource access, and communication practices that are suitable to their audiences.
This study applied a holistic, strength-based lens to better articulate the impetus for, and proc... more This study applied a holistic, strength-based lens to better articulate the impetus for, and processes of, informal recovery from gambling problems. Two research objectives framed the parameters of the study: to explore (a) the process by which gamblers move from recognition of a gambling problem to action for recovery and (b) the experiences, perceptions and contextual factors that shape the features of this process. Narrative telephone interviews were conducted with adult residents of Victoria, Australia. Thirty-two adult participants (22 males and 10 females) were recruited from the general community. All participants were self-identified as recovering or recovered from gambling problems. Participants primarily used informal recovery strategies, rather than professional services or support groups. The impetus for informal recovery was identified broadly as either (a) dissonance between desired and actual self-image and goals, (b) an uncontrollable adverse event, or (c) confrontation and decisive action by others affected by the individual's gambling involvement. The impetus, process and goals of recovery were best described by pathways that were distinguished by agency in recovery: externally directed and self-directed. The application of a strength-based lens helped to illuminate the role of agency in informal recovery. A proposed pathways framework may inform strength-based informal recovery strategies for gamblers and affected others, and therapeutic approaches. The pathways, which have not been articulated in previous gambling recovery literature, generally cohere with pathways articulated in the alcohol and substance recovery literature. In recent decades, the gambling industry has expanded into online platforms, and gambling products have become considerably more sophisticated and accessible (Australian Institute for
This study aimed to investigate the temporal benchmarks in informal gambling recovery pathways, w... more This study aimed to investigate the temporal benchmarks in informal gambling recovery pathways, with attention to the broader context of the experience for individuals, and to the experiences of young adults. While problem gambling counselling services are available and promoted, only a small proportion of those who experience gambling-related issues choose to resolve their problems with professional support. Rather, people attempt to recover through self-managed means such as self-help strategies and family support. Further, despite their increased vulnerability to gambling problems, young adults are greatly under-represented in treatment services, suggesting that young adults are even more likely to use informal means of recovery from problem gambling than older people. The majority of gambling recovery-related research to date has focused on formal treatment services and support programs such as Gambler’s Anonymous, which are most likely to be accessed by people with long-term, severe gambling problems. Gaps remain in the understanding of contextual factors throughout the process, and how they interact with changing self-awareness, and strategies to support recovery. This is particularly so in the case of young adults, whose experiences and expression of gambling recovery may differ from those of older adults given developmental differences and differences in the ways that young adults engage with gambling products. Narrative interviews with 32 young and older adults were conducted to develop an understanding of the motivations and experiences of informal recovery, and the social, environmental and temporal context of informal recovery. Narratives were analysed as a single unit, and attention was paid to any emerging differences in patterns for younger and older adults. Narrative analysis informed three key benchmarks in recovery: recognition of a problem; the impetus to initiate a recovery process; and the strategies used by participants to assist recovery. Differential patterns emerged in the ways that participants experienced these benchmarks but, interestingly, a key finding was in whether the recovering gambler was the agent in recovery, or whether they were compelled by someone or an event. In problem recognition, analysis defined (a) a self-recognised pathway, where the participant was positioned as agent in recognising their own problems, and (b) an externally recognised pathway, where the participant only actively recognised their problem after confrontation from someone close to them (e.g. a family member, friend or employer) or a significant negative event (e.g. hitting rock bottom). Similarly, analysis around the impetus for initiating the recovery process identified differences according to whether the participant was (a) the primary agent in recovery initiation and management to achieve personal goals and life-stage milestones that gambling had delayed (“selfdirected” pathway), or (b) had the recovery process imposed upon them by others who had been affected by their gambling, or a significant negative event (“externally directed” pathway). Regarding strategies used by individuals to resolve problems, the primary contribution of the current study was the identification of differential patterns in strategy management according to the individual's centrality of agency in recovery. The analysis revealed that recovery processes for younger and older participants were more similar than different, however some subtle differences emerged. In comparison to older participants, many young adults tended to have a strong sense of agency in recovery. While young adult participants described their gambling problem as an addiction, they also derived empowerment from a moment of clarity during an urge to gamble, where they felt they could make a decision not to gamble. This sense of empowerment motivated them throughout the recovery process. For many young adult participants, the process and outcome of successful recovery was defined by the prioritisation and pursuit of prosocial and conventional milestones for their age, such as maintaining a long-term romantic relationship, purchasing a home, travelling overseas, or career advancement. Importantly, the study found that delays in recognition of a gambling problem could relate to responses from significant others around the gambler, including the enabling effect of budgeting for gambling within household expenses and the normalisation of gambling and associated harms through others’ gambling. Additionally, the study found that workplaces can play an important role in supporting recovery through informal strategies as well as employer assistance programs. The strong moderating effect of personal, social, financial, and cultural resources on the process of recovery was highlighted, and articulated in terms of how they may impact on the experiences of each of the pathways. In light of these findings, the recovery capital construct that has been articulated in alcohol and other drug recovery literature is proposed as a framework to inform future research and gambling regulation. The findings demonstrated the potential for tailoring primary and secondary intervention and recovery strategies according to the age, and centrality of agency of the individual in the process of recovery.
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Papers by Sophie Vasiliadis
In 2013-14 the Australian Gambling Research Centre (AGRC) interviewed and surveyed government officials, service providers, researchers, and community and industry representatives involved in the gambling sector to identify their principal information and resource needs. The findings informed the development of the AGRC's research communication plan.
Organisations may use the findings of this summary to inform practices around information and resource access, and communication practices that are suitable to their audiences.