Online gambling behavior among medical students: the relationship with chronotype and social anxiety

Online gambling has become an increasingly prevalent form of digital risk behavior among university students, facilitated by continuous internet access and ease of engagement. This cross-sectional study aimed to examine associations of social anxiety and chronotype with online gambling behavior among 268 medical students. Data were collected using the Liebowitz Social Anxiety Scale (LSAS), Online Gambling Addiction Scale (OGAS), and Morningness–Eveningness Questionnaire (MEQ). Group comparisons and multivariable binary logistic regression were performed. Male students had significantly higher online gambling scores, whereas female students reported greater social anxiety and avoidance. First-year students exhibited higher anxiety, while third-year students tended toward higher OGAS scores. Morning-type students reported significantly higher anxiety and avoidance scores than intermediate and evening types. Due to a pronounced floor effect, OGAS scores were dichotomized as the minimum possible score (21) versus scores above 21. In multivariable analysis, accommodation type and smoking were independently associated with scoring above the OGAS minimum, whereas gender, social anxiety, social avoidance, and chronotype were not. These findings highlight associations with the dichotomized OGAS outcome rather than gambling severity and should be interpreted cautiously given the exploratory, cross-sectional design, which precludes causal inference.