Mechanisms of Action in the Relationship between Mindfulness and Problem Gambling Behaviour

  • Steven de Lisle
  • Nicki A. Dowling
  • J. Sabura Allen


Previous studies have found an inverse relationship between mindfulness and problem gambling severity. This paper presents the findings from two studies of treatment seeking problem gamblers designed to explore the role of mindfulness in problem gambling. Treatment-seeking problem gamblers displayed significantly lower mindfulness scores than adult community members and university students. Mindfulness was significantly related to most indices of gambling, and psychological distress was an important mechanism in these relationships. Rumination, emotion dysregulation and thought suppression were also implicated as mediators in the inverse relationship between mindfulness and psychological distress. Taken together, the findings provide theoretical support for existing models of mindfulness which suggest that mindfulness operates by reducing psychological distress through these cognitive mechanisms. They also suggest that mindfulness training may be a new and innovative avenue for therapy to improve treatment effectiveness for problem gambling.


Problem gambling Gambling Mindfulness Distress Rumination Emotion dysregulation Distress tolerance Thought suppression 


  1. Arch, J. J., & Craske, M. G. (2006). Mechanisms of mindfulness: Emotion regulation following a focussed breathing induction. Behav Res Ther, 44, 1849–1858.PubMedCrossRefGoogle Scholar
  2. Atlas, G. D., & Peterson, C. (1990). Explanatory style and gambling: How pessimists respond to losing wagers. Behav Res Ther, 28(6), 523–529.PubMedCrossRefGoogle Scholar
  3. Baer, R. A., Smith, G. T., Hopkins, J., Krietemeyer, J., & Toney, L. (2006). Using self-report methods to explore facets of mindfulness. Assessment, 13(1), 27–45.PubMedCrossRefGoogle Scholar
  4. Blaszczynski, A., & Nower, L. (2002). A pathways model for problem and pathological gambling. Addiction, 97(5), 487–499.PubMedCrossRefGoogle Scholar
  5. Borders, A., Earleywine, M., & Jajodia, A. (2010). Could mindfulness decrease anger, hostility, and aggression by decreasing rumination? Aggress Behav, 36, 28–44.PubMedCrossRefGoogle Scholar
  6. Bowen, S., Witkiewitz, K., Dillworth, T. M., & Marlatt, G. A. (2007). The role of thought suppression in the relationship between mindfulness meditation and alcohol use. Addict Behav, 32, 2324–2328.Google Scholar
  7. Brown, K. W., & Ryan, R. M. (2003). The benefits of being present: Mindfulness and its role in psychological well-being. J Pers Soc Psychol, 84(4), 822–848.Google Scholar
  8. Carlbring, P., & Smit, F. (2008). Randomized trial of internet-delivered self-help with telephone support for pathological gamblers. J Consult Clin Psychol, 76, 1090–1094.PubMedCrossRefGoogle Scholar
  9. Carmody, J., Baer, R. A., Lykins, E. L. B., & Olendzki, N. (2009). An empirical study of the mechanisms of mindfulness in a mindfulness-based stress reduction program. J Clin Psychol, 65, 613–626.PubMedCrossRefGoogle Scholar
  10. Chambers, R., Gullone, E., & Allen, N. B. (2009). Mindful emotion regulation: An integrative review. Clin Psychol Rev, 29, 560–572.PubMedCrossRefGoogle Scholar
  11. Christensen, D. R., Dowling, N. A., Jackson, A. C., Brown, M., Russo, J., Francis, K., & Umemoto, A. (2013). A pilot of an abridged Dialectical Behavior Therapy program as a treatment for problem gambling. Behaviour Change, 30, 117–137.CrossRefGoogle Scholar
  12. Ciarrocchi, J. W. (2002). Counseling problem gamblers: A self regulation manual for individual and family therapy. San Diego: Academic Press.Google Scholar
  13. Coffey, K. A., & Hartman, M. (2008). Mechanisms of action in the inverse relationship between mindfulness and psychological distress. Complementary Health Practice Review, 13(2), 79–91.Google Scholar
  14. Cowlishaw, S., Merkouris, S., Dowling, N., Anderson, C., Jackson, A., & Thomas, S. A. (2012). Psychological interventions for the treatment of pathological and problem gambling. Cochrane Database of Systematic Reviews, 11. Art. No.: CD008937.Google Scholar
  15. de Lisle, S., Dowling, N., & Allen, J. (2011). Mindfulness-based cognitive therapy for problem gambling. Journal of Clinical Case Studies, 10, 210–228.CrossRefGoogle Scholar
  16. de Lisle, S., Dowling, N. A., & Allen, S. J. (2012). Mindfulness and problem gambling: A review of the literature. J Gambl Stud, 28, 719–739.PubMedCrossRefGoogle Scholar
  17. Dowling, N. (2009). Client characteristics associated with treatment attrition and outcome in female pathological gambling. Addiction Research and Theory, 17(2), 205–219.CrossRefGoogle Scholar
  18. Dowling, N., Smith, D., & Thomas, T. (2006). Treatment of female pathological gambling: Efficacy of a cognitive-behavioural approach. J Gambl Stud, 22, 355–372.PubMedCrossRefGoogle Scholar
  19. Dowling, N., Smith, D., & Thomas, T. (2007). A comparison of individual and group cognitive behavioral treatment for female pathological gambling. Behav Res Ther, 45, 2192–2202.PubMedCrossRefGoogle Scholar
  20. Dowling, N., Smith, D., & Thomas, T. (2009). A preliminary investigation of abstinence and controlled gambling as self-selected goals of treatment for female pathological gambling. J Gambl Stud, 25(2), 201–214.PubMedCrossRefGoogle Scholar
  21. Feldman, G., Hayes, A., Kumar, S., Greeson, J., & Laurenceau, J.-P. (2007). Mindfulness and emotion regulation: The development and initial validation of the cognitive and effective mindfulness scale-revised (CAMS-R). Journal of Psychopathology and Behavioral Assessment, 29(3), 177–190.CrossRefGoogle Scholar
  22. Ferris, J., & Wynne, H. (2001). The Canadian Problem Gambling Index: User Manual. Ottawa: Canadian Centre on Substance Abuse.Google Scholar
  23. Hayes, S. C., & Feldman, G. (2004). Clarifying the construct of mindfulness in the context of emotion regulation and the process of change in therapy. Clinical Psychology: Science and Practice, 11(3), 255–262.Google Scholar
  24. Jackson, A. C., Wynne, H., Dowling, N. A., Tomnay, J. E., & Thomas, S. A. (2010). Using the CPGI to determine problem gambling prevalence in Australia: Measurement issues. International Journal of Mental Health and Addiction, 8, 570–582.CrossRefGoogle Scholar
  25. Jain, S., Shapiro, S. L., Swanick, S., Roesch, S. C., Mills, P. J., Bell, I., et al. (2007). A randomized controlled trial of mindfulness meditation versus relaxation training: Effects on distress, positive states of mind, rumination, and distraction. Ann Behav Med, 33, 11–21.PubMedCrossRefGoogle Scholar
  26. Kessler, R. C., Andrews, G., Colpe, L. J., Hiripi, E., Mroczek, D. K., Normand, S. L., et al. (2002). Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychol Med, 32(6), 959–976.PubMedCrossRefGoogle Scholar
  27. Korman, L., Collins, J., Littman-Sharp, N., Skinner, W., McMain, S., & Mercado, V. (2008). Randomized control trial of an integrated therapy for comorbid anger and gambling. Psychother Res, 18, 454–465.PubMedCrossRefGoogle Scholar
  28. Ladouceur, R., Lachance, S., & Fournier, P. M. (2009). Is control a viable goal in the treatment of pathological gambling? Behav Res Ther, 47(3), 189–197.PubMedCrossRefGoogle Scholar
  29. Lakey, C. E., Campbell, W. K., Brown, K. W., & Goodie, A. S. (2007). Dispositional mindfulness as a predictor of the severity of gambling outcomes. Personality and Individual Differences, 43, 1698–1710.PubMedCentralPubMedCrossRefGoogle Scholar
  30. Lee, T. K., LaBrie, R. A., Grant, J. E., Kim, S. W., & Shaffer, H. J. (2008). The structure of pathological gambling among Korean gamblers: A cluster and factor analysis of clinical and demographic characteristics. International Journal of Mental Health and Addiction, 6, 551–563.CrossRefGoogle Scholar
  31. Linehan, M. M. (1993). Cognitive-Behavioural Treatment of Borderline Personality Disorder. New York: Guilford Press.Google Scholar
  32. Lorains, F. K., Cowlishaw, S., Thomas, S. (2011). Prevalence of comorbid disorders in problem and pathological gambling: Systematic review and meta-analysis of population surveys. Manuscript submitted for publication.Google Scholar
  33. McIntosh, W. D., & Martin, L. L. (1992). The cybernetics of happiness: The relation between goal attainment, rumination, and affect. In M. S. Clark (Ed.), Review of personality and social psychology (Vol. 14, pp. 222–246). Newbury Park: Sage Publications.Google Scholar
  34. Najavits, L. M. (2003). How to design an effective treatment outcome study. J Gambl Stud, 19, 317–337.PubMedCrossRefGoogle Scholar
  35. Orford, J., Morison, V., & Somers, M. (1996). Drinking and gambling: A comparison with implications for theories of addiction. Drug Alcohol Rev, 15, 47–56.PubMedCrossRefGoogle Scholar
  36. Pallant, J. (2005). SPSS Survival Manual. Crows Nest: Allen & Unwin.Google Scholar
  37. Petry, N. M. (2005). Pathological gambling: Etiology, comorbidity, and treatment. Washington, D.C: American Psychological Association.CrossRefGoogle Scholar
  38. Petry, N. M., Ammerman, Y., Bohl, J., Doersch, A., Gay, H., Kadden, R., et al. (2006). Cognitive-behavioral therapy for pathological gamblers. J Consult Clin Psychol, 74(3), 555–567.PubMedCrossRefGoogle Scholar
  39. Preacher, K. J., & Hayes, A. F. (2008). Asympotic and resampling ‘procedures for assessing and comparing indirect effects in ’multiple mediator models. Behav Res Methods, 40, 879–891.PubMedCrossRefGoogle Scholar
  40. Ramel, W., Goldin, P. R., Carmona, P. E., & McQuaid, J. R. (2004). The effects of mindfulness meditation on cognitive processes and affect in patients with past depression. Cognitive Therapy and Research, 28(4), 433–455.CrossRefGoogle Scholar
  41. Ratelle, C. F., Vallerand, R. J., Mageau, G. A., Rousseau, F. L., & Provencher, P. (2004). When passion leads to problematic outcomes: A look at gambling. J Gambl Stud, 20(2), 105–119.PubMedCrossRefGoogle Scholar
  42. Raylu, N., & Oei, T. P. S. (2004). The Gambling Urge Scale (GUS): Development, confirmatory factor validation and psychometric properties. Psychol Addict Behav, 18, 100–105.PubMedCrossRefGoogle Scholar
  43. Reynolds, B., & Karraker, K. (2003). A Big Five model of disposition and situation interaction: why a “helpful” person may not always behave helpfully. New Ideas in Psychology, 21, 1–13.CrossRefGoogle Scholar
  44. Riley, B. (2012). Experiential avoidance mediates the association between thought suppression and mindfulness with problem gambling. Journal of Gambling Studies. Online First.Google Scholar
  45. Salovey, P., Mayer, J. D., Goldman, S., Turvey, C., & Palfai, T. (1995). Emotional attention, clarity, and repair: Exploring emotional intelligence using the trait meta-mood scale. In J. D. Pennebaker (Ed.), Emotional, Disclosure, and Health (pp. 125–154). Washington, DC: American Psychological Association.CrossRefGoogle Scholar
  46. Schmidt, R. E., Gay, P., Courvoisier, D., Oise Jermann, F., Ceschi, G., David, M., et al. (2009). Anatomy of the White Bear Suppression Inventory (WBSI): A review of previous findings and a new approach. Journal of Personality Assessment, 91(4), 323–330.Google Scholar
  47. Segal, Z. V., Williams, J. M. G., & Teasdale, J. D. (2002). Mindfulness-Based Cognitive Therapy for Depression: A New Approach to Preventing Relapse. New York: Guilford Press.Google Scholar
  48. Shapiro, S. L., Carlson, L. E., Astin, J. A., & Freedman, B. (2006). Mechanisms of mindfulness. J Clin Psychol, 62(3), 373–386.Google Scholar
  49. Shapiro, S., Brown, K., & Biegel, G. (2007). Teaching self-care to caregivers: Effects of Mindfulness-Based Stress Reduction on the mental health of therapists in training. Training and Education in Professional Psychology, 1(2), 105–115.CrossRefGoogle Scholar
  50. Shonin, E., van Gordon, W., & Griffiths, M. D. (2013a). Buddhist philosophy for the treatment of problem gambling. Journal of Behavioural Addictions, 2, 63–71.CrossRefGoogle Scholar
  51. Shonin, E., van Gordon, W., & Griffiths, M. D. (2013b). Mindfulness-based interventions for the treatment of problem gambling. Journal of the National Council on Problem Gambling, 16, 17–18.Google Scholar
  52. Shonin, E., van Gordon, W. V., & Griffiths, M. D. (2013c). Cognitive behavioural therapy (CBT) and meditation awareness training (MAT) for the treatment of co-occurring schizophrenia and pathological gambling: A case study. International Journal of Mental Health and the Addictions. Available online.Google Scholar
  53. Simons, J., & Gaher, R. (2005). The distress tolerance scale: Development and validation of a self-report measure. Motivation and Emotion, 29, 83–102.CrossRefGoogle Scholar
  54. Stewart, S. H., & Zack, M. (2008). Development and psychometric evaluation of a three-dimensional Gambling Motives Questionnaire. Addiction, 103, 1110–1117.PubMedCrossRefGoogle Scholar
  55. Tabachnick, B., & Fidell, L. S. (2001). Using Multivariate Statistics (4th ed.). Needham Heights, MA: Allyn & Bacon.Google Scholar
  56. Teasdale, J. D., Segal, Z. V., & Williams, J. M. G. (1995). How does cognitive therapy prevent depressive relapse and why should attentional control (mindfulness) training help? Behavioral Research and Therapy, 33, 25–39.CrossRefGoogle Scholar
  57. Thomas, S. A., Merkouris, S. S., Radermacher, H. L., Dowling, N. A., Misso, M. L., Anderson, C. J., & Jackson, A. C. (2011). An Australian guideline for treatment in problem gambling: An abridged outline. Medical Journal of Australia, 195(11), 664–665.PubMedCrossRefGoogle Scholar
  58. Toneatto, T., Vettese, L., & Nguyen, L. (2007). The role of mindfulness in the cognitive-behavioural treatment of problem gambling. Journal of Gambling Issues, 19, 91–100.CrossRefGoogle Scholar
  59. Trapnell, P. D., & Campbell, J. D. (1999). Private self-consciousness and the five-factor model of personality: Distinguishing rumination from reflection. J Pers Soc Psychol, 76(2), 284–304.PubMedCrossRefGoogle Scholar
  60. Wegner, D. M. (1989). White bears and other unwanted thoughts: Suppression, obsession, and the psychology of mental control. London: The Guilford Press.Google Scholar
  61. Wegner, D. M., & Erber, R. (1992). The hyperaccessibility of suppressed thoughts. J Pers Soc Psychol, 63, 903–912.CrossRefGoogle Scholar
  62. Wegner, D. M., & Zanakos, S. (1994). Chronic thought suppression. J Pers, 62, 615–640.Google Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Steven de Lisle
    • 1
  • Nicki A. Dowling
    • 1
    • 2
    • 3
  • J. Sabura Allen
    • 1
  1. 1.School of Psychological SciencesMonash UniversityMelbourneAustralia
  2. 2.School of Psychology, Faculty of HealthDeakin UniversityMelbourneAustralia
  3. 3.Problem Gambling Research and Treatment CentreUniversity of MelbourneMelbourneAustralia

Personalised recommendations