Examining the Strength of the Association Between Problem Gambling and Gambling to Escape: A Systematic Review and Meta-Analysis

Gambling to escape is often purported to play a central role in the maintenance of problem gambling. However, the strength and consistency this association is unknown. Therefore, the current systematic review and meta-analysis was conducted to explore the association between gambling to escape and problem gambling. The study protocol was registered in the PROSPERO database and protocols were developed and published studies were searched until May 2024. The PRISMA standards were adopted for screening and extraction of relevant data. Twenty-seven studies that measured gambling motives, reasons, or expectancies, related to escape, using validated multiple item measures, were included. Positive associations were found between gambling to escape and problem gambling, and this association remained after controlling for the effect of gambling for financial gain. Additional subgroup analyses were conducted to test the stability of the association by escape measure. Although the magnitude of the positive association changed depending on the scales used, the positive relationship held. The findings support the contention that problem gambling is at least, in part, maintained by the escape afforded by gambling—indicating the importance considering the emotion focused reasons in the design of initiative to reduce problem gambling behaviours.