Risk factors for the development of problem gambling in individuals with ADHD symptoms: The mediating roles of gambling engagement and ADHD characteristics.

Gambling disorder is a behavioral addiction characterized by impulsivity and problem gambling, and it often cooccurs with ADHD. This study investigated the associations between ADHD symptoms and problem gambling, focusing on the roles of various forms of gambling engagement. Based on data from the JASTIS 2024 survey, which included 29,268 valid respondents, this cross-sectional study explored how ADHD symptoms are related to the prevalence of problem gambling and specific forms of gambling engagement. Problem gambling was assessed using the Problem Gambling Severity Index, and ADHD symptoms were measured with the Japanese version of the Adult ADHD Self-Report Scale. The results revealed that 22.2 % of the participants with ADHD symptoms exhibited problem gambling, this proportion was significantly higher than that reported in the general population. Causal mediation analysis revealed that all types of gambling engagement, except for lottery, mediated the relationship between ADHD symptoms and problem gambling. Among them, bicycle racing and online casinos exhibited the strongest effects. Multiple regression analysis revealed that online casino use was the strongest predictor of problem gambling both in the general population and among individuals with ADHD symptoms. These findings suggest that individuals with ADHD characteristics increase the risk of engaging in gambling activities, particularly casino and online gambling, which have a high potential for addiction. Given the association between problem gambling and casino-related experiences, this study underscores the need for stringent regulatory measures and targeted prevention strategies, particularly as Japan considers expanding casino operations.