Journal of Gambling Studies

, Volume 27, Issue 1, pp 73–81 | Cite as

Metacognitions in Problem Gambling

  • Annika Lindberg
  • Bruce A. Fernie
  • Marcantonio M. Spada
Original Paper


Problem gambling is heterogeneous in nature, ranging in severity from occasional but problematic gambling episodes, to extreme, impulsive and pervasive gambling behaviour. Problem gambling may be accompanied by a sense of impaired control and can give rise to financial, interpersonal, legal and vocational costs for the sufferer, their families and society. This study investigated the relationship among metacognitions, anxiety, depression and gambling in a sample of problem gamblers. A total of 91 individuals attending gambling treatment services completed a battery of self-report instruments that consisted of the Metacognitions Questionnaire 30 (MCQ-30), the Hospital Anxiety and Depression Scale (HADS) and the South Oaks Gambling Scale (SOGS). Correlation analyses showed that anxiety, depression and metacognitions were positively and significantly correlated with both gambling consequences and behaviour. Hierarchical regression analyses indicated that two metacognitive constructs (negative beliefs about thoughts concerning uncontrollability and danger and beliefs about the need to control thoughts) predicted gambling behaviour independently of anxiety and depression. These findings are consistent with the hypothesis that metacognitions play a role in problem gambling.


Anxiety Depression Gambling Metacognitions Problem gambling 


  1. Battersby, M. W., Thomas, L. J., Tolchard, B., & Esterman, A. (2002). The South Oaks Gambling Screen: A review with reference to Australian use. Journal of Gambling Studies, 18, 257–271.PubMedCrossRefGoogle Scholar
  2. Blasé, G., & Lesieur, H. R. (2006). The South Oaks Gambling Screen (SOGS): A rebuttal to critics. Journal of Gambling Issues, 17. Google Scholar
  3. Bouman, T. K., & Meijer, K. J. (1999). A preliminary study of worry and metacognitions in hypochondriasis. Clinical Psychology and Psychotherapy, 6, 96–101. Special issue, Metacognition and Cognitive Behaviour Therapy. Chichester, UK: Wiley.Google Scholar
  4. Cox, S., Lesieur, H. R., Rosenthal, R. J., & Volberg, R. A. (1997). Problem and pathological gambling in America: The national picture. Columbia, MD: National Council on Problem Gambling.Google Scholar
  5. Crockford, D. N., & el-Guebaly, N. (1998). Psychiatric comorbidity in pathological gambling—a critical review. Canadian Journal of Psychiatry, 43, 43–50.Google Scholar
  6. Ferris, J., & Wynne, H. (2001). The Canadian Problem Gambling Index: Final Report. Ottawa, ON, Canada: Canadian Centre on Substance Abuse.Google Scholar
  7. Gaboury, A., & Ladouceur, R. (1989). Erroneous perceptions and gambling. Journal of Social Behaviour and Personality, 4, 411–420.Google Scholar
  8. Hayes, S. C. (2004). Acceptance and commitment therapy, relational frame theory, and the third wave of behavior therapy. Behavior Therapy, 35, 639–665.CrossRefGoogle Scholar
  9. Herrmann, C. (1997). International experiences with the Hospital Anxiety and Depression Scale—a review of validation data and clinical results. Journal of Psychosomatic Research, 42, 17–41.PubMedCrossRefGoogle Scholar
  10. Ladouceur, R. (1996). The prevalence of pathological gambling in Canada. Journal of Gambling Studies, 12, 129–142.CrossRefGoogle Scholar
  11. Lesieur, H. R., & Blume, S. B. (1987). South Oaks Gambling Screen (SOGS): A new instrument for the identification of pathological gamblers. American Journal of Psychiatry, 144, 1184–1188.PubMedGoogle Scholar
  12. Morrison, A. P., Wells, A., & Nothard, S. (2000). Cognitive factors in predisposition to auditory and visual hallucinations. British Journal of Clinical Psychology, 39, 67–78.PubMedCrossRefGoogle Scholar
  13. Mykletun, A., Stordal, E., & Dahl, A. A. (2001). Hospital Anxiety and Depression Scale: Factor structure, item analyses and internal consistency. British Journal of Psychiatry, 179, 540–544.PubMedCrossRefGoogle Scholar
  14. Oliveira, M. P., Silva, M. T. A., & da Silveira, D. X. (2002). Validity study of the South Oaks Gambling Screen (SOGS) among distinct groups of Brazilian gamblers. Rev Bras Psiquiatr, 24, 170–176.CrossRefGoogle Scholar
  15. Papageorgiou, C., & Wells, A. (2003). An empirical test of a clinical metacognitive model of rumination and depression. Cognitive Therapy and Research, 27, 261–273.CrossRefGoogle Scholar
  16. Petry, N. M., Stinson, F. S., & Grant, B. F. (2005). Comorbidity of DSM-IV pathological gambling and other psychiatric disorders: Results from the National Epidemiologic Survey on Alcohol and Related Conditions. Journal of Clinical Psychiatry, 66, 564–574.PubMedCrossRefGoogle Scholar
  17. Roussis, P., & Wells, A. (2006). Post-traumatic stress symptoms: Tests of relationships with thought control strategies and beliefs as predicted by the metacognitive model. Personality and Individual Differences, 40, 111–122.CrossRefGoogle Scholar
  18. Segal, Z., Williams, J. M. G., & Teasdale, J. (2002). Mindfulness-based cognitive therapy for depression. New York, USA: Guilford Press.Google Scholar
  19. Shaffer, H. J., & Hall, M. N. (2001). Updating and refining meta-analytic prevalence estimates of disordered gambling behavior in the United States and Canada. Canadian Journal of Public Health, 92, 17–168.Google Scholar
  20. Sharpe, L. (2002). A reformulated cognitive-behavioural model of problem gambling: A Biopsychosocial perspective. Clinical Psychology Review, 22, 1–25.PubMedCrossRefGoogle Scholar
  21. Snaith, R. P., & Zigmond, A. S. (1994). HADS: Hospital Anxiety and Depression Scale. Windsor, UK: NFER Nelson.Google Scholar
  22. Spada, M. M., Caselli, G., & Wells, A. (2009). Metacognitions as a predictor of drinking status and level of alcohol use following CBT in problem drinkers: A prospective study. Behaviour Research and Therapy, 47, 882–886.PubMedCrossRefGoogle Scholar
  23. Spada, M. M., Hiou, K., & Nikčević, A. V. (2006a). Metacognitions, emotions and procrastination. Journal of Cognitive Psychotherapy, 20, 319–326.CrossRefGoogle Scholar
  24. Spada, M. M., Mohiyeddini, C., & Wells, A. (2008a). Measuring metacognitions associated with emotional distress: Factor structure and predictive validity of the Metacognitions Questionnaire 30. Personality and Individual Differences, 45, 238–242.CrossRefGoogle Scholar
  25. Spada, M. M., Nikčević, A. V., Moneta, G. B., & Ireson, J. (2006b). Metacognition as a mediator of the effect of test anxiety on surface approach to studying. Educational Psychology, 26, 1–10.CrossRefGoogle Scholar
  26. Spada, M. M., Nikčević, A. V., Moneta, G. B., & Wells, A. (2007). Metacognition as a mediator of the relationship between emotion and smoking dependence. Addictive Behaviors, 32, 2120–2129.PubMedCrossRefGoogle Scholar
  27. Spada, M. M., Nikčević, A. V., Moneta, G. B., & Wells, A. (2008b). Metacognition, perceived stress, and negative emotion. Personality and Individual Differences, 44, 1172–1181.CrossRefGoogle Scholar
  28. Sproston, K., Erens, B., & Orford, J. (2000). Gambling Behaviour in Britain: Results from the British Gambling Prevalence Survey. London, UK: The National Centre for Social Research.Google Scholar
  29. Stewart, S. H., Zack, M., Collins, P., Klein, R. M., & Fragopoulos, F. (2008). Subtyping pathological gamblers on the basis of affective motivations for gambling. Relations to gambling problems, drinking problems and affective motivations for drinking. Psychology of Addictive Behaviors, 22, 257–268.PubMedCrossRefGoogle Scholar
  30. Teasdale, J. D., & Barnard, P. J. (1993). Affect, cognition and change: Re-modelling depressive thought. Hove, UK: Lawrence Erlbaum Associates.Google Scholar
  31. Toneatto, T. (1999). Cognitive psychopathology of problem gambling. Substance Use and Misuse, 34, 1593–1604.PubMedCrossRefGoogle Scholar
  32. Toneatto, T. (2005). A perspective on gambling treatment: Issues and challenges. Journal of Gambling Studies, 21, 92–100.CrossRefGoogle Scholar
  33. Toneatto, T., & Millar, G. (2004). The assessment and treatment of problem gambling: Empirical status and promising trends. Canadian Journal of Psychiatry, 49, 173–181.Google Scholar
  34. Toneatto, T., Vettese, L., & Nguyen, L. (2007). The role of mindfulness in the cognitive-behavioural treatment of problem gambling. Journal of Gambling Issues, 19, 92–100.CrossRefGoogle Scholar
  35. Wells, A. (1995). Meta-cognition and worry: A cognitive model of generalized anxiety disorder. Behavioural and Cognitive Psychotherapy, 23, 301–320.CrossRefGoogle Scholar
  36. Wells, A. (2000). Emotional disorders and metacognition: Innovative cognitive therapy. Chichester, UK: Wiley.Google Scholar
  37. Wells, A. (2008). Metacognitive therapy for anxiety and depression. New York, USA: Guilford Press.Google Scholar
  38. Wells, A., & Cartwright-Hatton, S. (2004). A short form of the meta-cognitions questionnaire: Properties of the MCQ-30. Behavior Therapy, 42, 385–396.CrossRefGoogle Scholar
  39. Wells, A., & Matthews, G. (1996). Modelling cognition in emotional disorder: The S-REF model. Behaviour Research and Therapy, 34, 881–888.PubMedCrossRefGoogle Scholar
  40. Wells, A., & Papageorgiou, C. (1998). Relationships between worry and obsessive-compulsive symptoms and meta-cognitive beliefs. Behaviour Research and Therapy, 36, 899–913.PubMedCrossRefGoogle Scholar
  41. Zigmond, A. S., & Snaith, R. P. (1983). The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica, 67, 361–370.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Annika Lindberg
    • 1
  • Bruce A. Fernie
    • 2
  • Marcantonio M. Spada
    • 3
    • 4
  1. 1.National Gambling ClinicSoho Centre for HealthLondonUK
  2. 2.Fatigue ServiceRoyal Free HospitalLondonUK
  3. 3.Department of Mental Health and Learning Disabilities, Faculty of Health and Social CareLondon South Bank UniversityLondonUK
  4. 4.North East London NHS Foundation TrustLondonUK

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