Cutting the odds: Understanding non-suicidal self-injury patterns among people gambling online

Abstract

Background and aims: Non-suicidal self-injury (NSSI) and gambling are considered notable public health challenges, each linked to emotion dysregulation, impulsivity, and heightened mental health risks. Although examined separately, their co-occurrence may reflect overlapping vulnerabilities. The present study examined the prevalence, correlates, and predictors of NSSI among ndividuals who gamble online and identified distinct behavioral subgroups using latent class analysis. Methods: A cross-sectional study was conducted among individuals with past-year online gambling (N = 1047; 50% males; mean age = 39.60 years [SD = 12.46]). Measures included psychometric scales assessing problem-gambling severity, NSSI, impulsivity, sleep difficulties, and psychological distress. Multinomial logistic regressions tested associations between gambling severity and NSSI, and latent class analysis (LCA) was conducted to identify NSSI subgroups. Hierarchical multinomial regressions assessed demographic, gambling-related, and psychological predictors of class membership. Results: Lifetime NSSI was reported by 64% of participants, with higher odds among those with scores reflecting problem gambling. LCA identified three subgroups: low/no self-harming (61.6%), moderate/occasional self-harming (23.2%), and high/multi-method self-harming (15.2%), reflecting stepwise increases in frequency and method diversity. NSSI class membership was significantly associated with problem-gambling severity (chi(2)[3] = 45.0, p < .001). Younger age, insomnia, impulsivity, and psychological distress predicted higher NSSI class membership, with insomnia and distress emerging as the strongest independent predictors. Conclusion: NSSI is a prevalent and clinically significant correlate of online gambling, emerging even at lower levels of problem-gambling severity, underscoring the importance of integrating emotion regulation and distress-focused support into interventions targeting problem gambling. The study's findings deepen the understanding of psychological pathways linking gambling and self-injury among adults.