Climate change anxiety among psychiatric outpatients: associations with psychiatric symptoms and experience with climate change and natural disasters.

According to the World Health Organization (WHO), adolescence is a transitional period marked by significant physical, psychological, and social changes (). This stage is also associated with an increased likelihood of engaging in risky behaviours, including alcohol consumption, substance use, and delinquency (). Gambling with money is increasingly recognised as another form of risk behaviour during adolescence. These behaviours often co-occur, forming interconnected patterns that may reinforce each other and increase vulnerability to negative outcomes in both adolescence and adulthood (, ). Previous research has shown that individuals who engage in gambling are more likely to smoke and consume alcohol at hazardous levels (, ), highlighting the importance of understanding gambling within a broader constellation of risk behaviours. Excessive gambling is considered a behavioural addiction and has gained increasing attention as a public health concern in recent years (, ). In Spain, regulatory frameworks have struggled to keep pace with the rapid evolution of gambling environments, particularly in relation to underage gambling. Although policies such as Royal Decree 958/2020 impose restrictions on minors’ access to gambling establishments, these measures are less effective in addressing the growing prevalence of online gambling, where most adolescent exposure now occurs. At the European level, gambling is generally prohibited for minors (). However, adolescents continue to engage in gambling activities despite these restrictions (–). This persistence is partly explained by increased exposure to gambling-related marketing, including advertising during sports events and integration within digital platforms and online games (). Furthermore, gambling is often socially normalised as a form of entertainment in many contexts (–), which may further reduce perceived risk amongst young people.