The high occurrence of cross-sectional studies does not allow us to clearly define the relationship’s direction between psychological distress and problem gambling. It is difficult to establish whether the former is a risk factor or an outcome of the latter. For example, it is unclear whether a high level of psychological distress is a consequence of frequent gambling or conversely whether people with psychological distress are particularly attracted to gambling. Predictably, a higher level of psychological distress was found in online gamblers more at risk of problem gambling than in low-risk gamblers (Gainsbury et al., 2014b; Granero et al., 2020; Hing et al., 2017; Hopley & Nicki, 2010). Anxiety and depression were the main experiences studied and reported by pathological gamblers at higher rates (Barrault & Varescon, 2013a; Barrault et al., 2017; Hopley & Nicki, 2010; Khazaal et al., 2017). In addition, mood disturbances such as hypomanic experiences and mood elevation are reported to a greater extent in the most problematic cluster (Lloyd et al.

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