Compulsive gambling and the medical model

The medical model as a conceptual and operative approach to compulsive gambling is discussed. The terms medical model and disease are defined and the practical implications of their application to compulsive gambling are explored. Special attention is given to the addictive disease concept. Finally, a variety of objections to the medical model are described, but it is concluded that the many individual and social advantages of the medical model make it the preferred conceptualization at our present state of knowledge.     

Behavior Genetic Research on Gambling and Problem Gambling: A Preliminary Meta-Analysis of Available Data

A meta-analysis of family and twin studies on gambling and problem gambling was initiated in an effort to determine the probable role of genetic factors in high risk wagering. Two twin studies and 17 investigations employing the family history or family study method were included in this meta-analysis. A summation of the 19 studies produced a small but significant overall effect size (weighted = .10, unweighted = .13), with both family (weighted = .12, unweighted = .14) and twin (weighted = .06, unweighted = .05) studies achieving significant individual mean effects. Given the paucity of twin data, further analysis was confined to family studies and revealed a stronger familial effect for the sons of problem gambling fathers than for the daughters of problem gambling mothers and for more severe forms of problem gambling than for less severe forms of problem wagering, and was strongest for high severity problem gambling in males. The implications of these results are discussed.     

The ethics of gambling research: an agenda for mature analysis

The purpose of this article is to explore the ethics of both the anti-gambling and pro-gambling groups as they present their research into the gambling phenomenon. The type of ethical thinking that each group uses will be characterized to show how their ethical views have caused their research to be biased. The second part of this article proposes a modest research agenda for future gambling studies. This agenda rests a foundation of a mature ethical thinking.     

Problem gambling: One view from the gaming industry side

An experienced lawyer for the gaming industry argues that the very appellation of compulsive gambling is misleading. Advocates of the medical model of compulsive gambling have created a strange new disease, where individuals are viewed as not responsible for their misdeeds but as solely responsible for their own cure. The fact that some individuals have problems because of gambling does not lead to the conclusion that casinos bear the ultimate legal or moral responsibility. More research and dialogue is needed; but so is the acceptance by problem gamblers and those who study and treat them that individuals have to take responsibility for their own conduct.     

Theory at risk: Accounting for the excellence movement

Amidst widespread concern about educational crisis and the need for reform, the current excellence movement places a pronounced emphasis on rigor, standards, and a core curriculum of basic studies. At issue here is whether major macro-the-oretical perspectives can account for the emergence of this movement. Functional and Marxian theories do not meet this challenge well, especially insofar as they posit a tight, rational linkage between school and economy and downplay the institutional autonomy of the educational system. A status conflict approach, emphasizing middle class mobilization, offers greater insight, though it must be complemented with a recognition of constraints imposed by capitalist organization and the institutionalization of educational myths.     

Muddying the Waters Does Not Have to Entail Erosion: Ecological Feminist Concerns with Purity

Ecofeminists call attention to the associations that have been made between woman and nature, which can operate as a source of both subjugation and resistance, exploitation, and inspiration. This paper expands upon feminist critiques of purity by phrasing these concerns in an ecological feminist perspective. This theoretical exercise of problematizing the ideal of purity sheds light upon the intersections of human and nonhuman oppression. Preservationist work has tended to employ the logic of purity by focusing on protection of the purity of the wild regions of the earth from the polluting forces of humanity. However, such approaches retain the troublesome nature/culture dualism. The author illustrates how attempts to fragment and radically separate people from the environment can prove to be highly dangerous. She connects the theoretical resistance to purity to the important activist work that is being done to expose environmental racism. Finally, she discusses how muddying the waters and resisting the logic of purity can offer a promising approach to pressing problems revolving around the intersections of human and nonhuman oppression.     

The prevalence rates of pathological gambling: A look at methods

Planning the gambling environment requires protection of the public's health, safety and welfare. Whereas most public gaming provisions and statutes address the public's fears of organized crime as well as some welfare needs, rarely do they safeguard the public's health regarding the spread of the mental disease known as pathological gambling. Measurement of the prevalence and incidence of this disease would enable policy planners to evaluate both the state's responsibility for an epidemic and the adequacy of publicly funded treatment programs. The purpose of this paper is to examine the methods which underlie three different estimates of the prevalence rate of pathological gambling and to critique them in the light of sound epidemiological procedure. In 1975, the Institute for Social Research (ISR) of the University of Michigan conducted a national survey and a survey of the state of Nevada on behalf of the U.S. Commission on a National Policy Toward Gambling. Using discriminant function analysis coupled with subjective inspection of cases in the at-risk pool, the researchers estimated rates of probable and potential pathological gamblers. In 1984 and 1985, this author surveyed residents in the Delaware Valley and the state of Ohio using the cumulative clinical signs method which also posited rates of probable and potential pathological gamblers. In 1986, researchers at the Office of Mental Health for the State of New York employed a formal screening device to survey residents and proposed a rate of probable pathological gamblers and a rate of problem — although not pathological — gamblers. All three approaches produced different estimates. The utility of prevalence and incidence rate research in this field is threatened by a lack of consensus about the proper epidemiological procedure to be employed in arriving at these estimates. There is also confusion about the distinction between a probable and a potential pathological gambler. The planning purpose, method, validity and reliability of prevalence rate research about pathological gambling are addressed in this paper.     

A Comparison of Hispanic and Anglo Calls to a Gambling Help Hotline

Prevalence studies have found that problem gamblers tend to be non-Caucasians. Nevertheless, information on non-Caucasian gambling patterns and problems is virtually non-existent. Data collected during years 1992–1998 on Hispanic (N = 209) and Anglo (N = 5311) problem gamblers calling the Florida Council on Compulsive Gambling Hotline for help is examined to provide information on one such non-Caucasian group: Hispanics. A sharp difference in the number of Hispanic and Anglo callers was found during this six year period (3.8% Hispanic and 96.2% Anglo). Differences were also found in the likelihood of Hispanics calling about their own problems, having gone for previous help, and types of gambling activities. Similarities were found between the two groups regarding age, marital status, and the three most cited problems caused by gambling: problems with family, inability to pay bills and going into debt. Anglos were significantly more likely to engage in illegal activities for gambling money and problems with job. Group differences caution against using Anglo based prevention and treatment programs with Hispanics populations.     

Compulsive gambling in Britain

In 1968 England legalized casino gaming. Unlike their counterparts in America, legislators in the House of Lords actively debated ways to help compulsive gamblers. Parliament adopted the 48 hour rule, requiring players to wait two days before gambling, put severe restrictions on check cashing in casinos and, limited the number of slot machines to two per club. England considered, but rejected, other proposals: the method, used in France, of allowing compulsive gamblers to voluntarily put their names on a list of persons to be excluded and, complete prohibitions on casino credit. Although the legislative restrictions greatly reduced compulsive gambling among adult gamers; sadly, Parliament ignored what has become a growing source of compulsive gambling among children: the practically unlimited availability of public arcades with amusement machines paying small cash prizes.The author wishes to thank James Claber for assistance in this article.     

Social Defenses Against Organizational Learning

It is argued that for organizational learning to occur maladaptive social defenses within the organization have to be altered. The origins of the concept of social defenses are traced through the work of Jaques and Menzies. A new concept of system domain, and related concepts of system domain fabric, and system domain defenses, are proposed in order to account for the difficulties in sustaining organizational change in organizations that share a similar primary task. Organizational learning is defined as occurring when there is co-evolution of organizational container and contained. The article distills variables from three successful consultancy/action research projects which are characteristic of organizations that are learning, and it is hypothesized that the creation of organizational awareness is necessary for organizational learning to occur.     

Minimal treatments and problem gamblers: A preliminary investigation

In view of the increasing popularity of minimal intervention treatments for problem drinking, a self-help manual for people who wish to reduce or stop gambling was prepared. Twenty-nine (ACT residents) who responded to advertisements for help with problem gambling were allocated to either of two minimal treatments, Manual (only) and Manual & Interview. On average, clients from both groups reduced the frequency of their gambling sessions, frequency of overspending, and amount spent per week in the first three months and next three months after first contact, but expenditure per session increased from three to six months, after an initial improvement. There was no evidence that a single in-depth interview added to the effectiveness of the manual.This project was funded by a grant from the Australian National University Faculties Research Fund.     

The emergence of Dutch casinos: A case study of mismarketing?

Ostensibly, the approval of legalized casino type gambling in the Netherlands was intended to combat illegal and uncontrolled gambling. Very early on, however, the plan conceived and implemented by the Netherlands Parliament demonstrated serious mismarketing strategies and tactics. The new legal casinos were appealing to people other than those engaged in illegal gambling, in particular foreign tourists and local high rollers. This paper attempts to analyze the ultimate process of goal displacement, as the state casino industry allowed economic objectives to supplant desires to utilize legal casinos primarily as controls over illegal gambling.     

The treatment model of the guidance center for gamblers and their relatives in Vienna/Austria

Within 8 years, Gamblers Anonymous in Vienna evolved into a guidance center for gamblers and their relatives, with professional aid. It is a non-profit institution and the therapeutic team consists of one psychologist, one social-worker and one psychiatrist. The clients can remain anonymous, but about 90% of them reveal their identity. The treatment model integrating professional therapy and self-help is presented. The reasons we decided to base our work on an addiction model of pathological gambling are explained. All the clients consulting our center in 1990 (N=237) are described according to age, sex, types of gambling, duration of problem gambling, family status, profession, income, debts, and income/debt relationship. Finally, the treatment program of our center is presented.This article is an extension of the special issue on Gambling in Europe edited by Iver Hand, M.D.     

La Terza Via

Conclusion From these critical contributions, it is clear that there exists, among secondary commentators, extensive support for Carl Boggs's claim that the strategy of the Southern European communist parties, and the PCI in particular, represents not an optimistic third path but a return to the original path of Bernsteinian social democracy. There is also evident a widespread, if not universal, belief that orthodox leninism does not offer a satisfactory alternative. But while the standing of the PCPs Terza Via as an alternative to either social democracy or leninism is thus repeatedly questioned, counterposed authentically distinctive and radical accounts of the third way are, at best, rudimentary. Though not wholly unsupported, the advocacy of anti-passive revolution or sweeping transformation of the state gives very little indication of what an alternative third way would entail in practice in, for example, the Italian context. This is clearly one source of the PCI's impatience with its overly theoretical critics.If the suggestions of Buci-Glucksmann, Poulantzas, and others are too general and programmatic, it is possible that a practical alternative to the established party interpretation of the Terza Via might be sought among differing positions within the PCI. If we take the PCI's most recent strategy - the pursuit of the Democratic Alternative - it is indeed possible to identify significant divergences between right and left. As presented by Berlinguer, the strategy of Democratic Alternative was seen to consummate a breach with the Historic Compromise - a move away from Christian Democracy in favor of a left alternative, a move away from an exclusive reliance upon parliamentary alliance in favor of a mobilisation of social forces and movements. But he continued to emphasize that the party's electoral strength... is still the decisive factor in changing the balance of forces in favor of the alternative, while Napolitano, speaking for the right of the party, has tended to view the Democratic Alternative as a strategy for party and parliamentary alliance with the PSI, as the basis of a government able to pursue a policy for the relaunching of (economic) development in such a way as to avoid fuelling inflation. By contrast, Pietro Ingrao, spokesperson of the left of the party, has insisted that the alternative is not simply a proposal for central government and he has given much more weight to the promotion of a more general radical social movement organized around the pursuit of radical social alliances, built upon greater local autonomy and in-party democracy.But it is not clear that (even) this left variant of the Democratic Alternative has defined the grounds upon which a more radical Tefza Via could be constructed. Indeed, the experience of the PCI strategists themselves lends considerable support to the belief that there are chronic difficulties in overcoming the social democracy-leninism divide from within even a broadly conceived Marxian framework. For example, the experience of the new social movements - to which all sides of the PCI express themselves to be open - illustrates the considerable difficulties of comprehending the diversity of contemporary emancipatory struggles with the tools of conventional Marxian class analysis. Similarly, the ambivalence of state action - neatly captured in Offe's claim that socialism in industrially advanced societies cannot be built without state power and it cannot be built upon state power - is illcomprehended by classical Marxist accounts of the capitalist state and its withering away. In short, the evidence of the Italian experience suggests both that an emancipatory politics is perhaps not best understood as the pursuit of a third road to socialism and that, in fact, such a politics can no longer be exclusively based upon Marxian premises. Contemporary circumstances suggest the need for a new evaluation of the nature of state and civil society and a view of democracy and pluralism quite at variance with the rudimentary positions of both social democracy and leninism.If the capacity of the left wing of the PCI to respond to this challenge is doubtful, the prospects of the mainstream PCI meeting it are minimal. For they are resolutely committed to a reformist interpretation of the Terza Via in which a deeply entrenched commitment to Marxism as an objectivistic theory of social development seems to legitimate, as it did for the Second International, a largely reformist practice. But, at the same time, it should be clear that this is a commitment that arises less from doctrinal preferences than from the institutional and practical dilemmas experienced by any socialist party seeking mass electoral support. It is a difficulty starkly posed by Przeworski: Participation in electoral politics is necessary if the movement for socialism is to find mass support among workers, yet this participation seems to obstruct the attainment of final goals. Under the peculiar exclusionary circumstances of Italian politics, this problem is especially pronounced. In the election of 1983, under the new strategy, the Communist vote held up quite well, (down 0.5% at 29.9%), while the DC tumbled from 38.3% to 32.9%. In the European elections of 1984, the PCI even crept ahead of the DC. But despite these historical reversals for Christian Democracy, Italy continued to be governed by a DC-PSI coalition, under the premiership of the PSI leader Bettino Craxi. Committed to an electoral strategy, the Italian communists - powerful in the unions, strongly embedded in civil society, experienced and widespread in local government, consistently able to secure around a third of the popular vote - still found themselves excluded from governmental power.The irony of the PCI's position is neatly caught by Middlemas: the PCI has come closer than any other CP to bridging the ancient gap between the Second and Third Internationals, yet the only fruit appears to be that it has inherited what in the halcyon mid-70s it used to call the crisis of social democracy. While elements of a radical third way may indeed be found in the experience of Italian Marxism, the PCI repeatedly finds its options foreclosed, on the one hand, by the limitations of social democracy and, on the other, by the unacceptability of leninism. Indeed, its continuing difficulties, in the face of its very considerable strengths, lend further support to the claim that even a quite radically reconstructed Marxism is inadequate to the task of defining a satisfactory basis for a democratic socialist politics. This is evident in the circumlocutions in which the PCI has found itself involved in reconciling its day-to-day political practice to the broadest parameters of Marxian analysis. From this, it seems clear that if a radical Terza Via is indeed to emerge, it is unlikely to arise from within the mainstream of Italian Communism.

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La Terza Via

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Video lottery gambling: Effects on pathological gamblers seeking treatment in South Dakota

Fifty-eight pathological gamblers receiving treatment for addictive illness in two South Dakota hospitals were assessed for types of gambling and grouped into three categories; 15 video lottery only (VLO), 36 video lottery mixed (VLM), and 7 not video lottery (NVL). There were 51 male and 7 female respondents, with a mean age of 38.2. We hypothesized that video lottery would be the predominant type of gambling on several dimensions: level of recent activity, most money lost on one occasion, and number of DSM-IV criteria met. Of all gamblers, 87.9% had pathological involvement with video lottery. Video lottery gambling accounted for the highest level of recent activity. In the VLM group, video lottery gambling led to greater single-occasion monetary losses. In addition, significantly more DSM-IV criteria were met in the VLM group for video lottery gambling than for other forms of gambling these subjects had engaged in. Results indicate that video lottery gambling is the predominant type of gambling behavior engaged in by gamblers seeking treatment for addictive illness in South Dakota. We propose that these findings could be associated with the availability and stimulus differences between video lottery and other gambling types.The authors would like to thank Larry Atwood, Chemical Dependency Counselor at Keystone Treatment Center in Canton, S.D., for his assistance with data collection.     

Rapid onset of pathological gambling in machine gamblers

A particularly rapid onset of pathological gambling (PG-onset) through the use of gambling machines has been widely alluded to, but this is the first study to empirically examine the phenomenon. This study compared the latency of PG-onset in those who gambled primarily on machines, compared to those who gambled primarily on more traditional forms of gambling at PG-onset. Subjects were 44 adult pathological gamblers (PGs) seeking outpatient treatment in Rhode Island (17 females; mean age = 46.9). Subjects completed questionnaires and a diagnostic interview including a complete history of gambling activities and the course of PG. The latency of PG-onset was defined as the time (in years) elapsed between the age of regular involvement in the primary form of gambling and the age at which DSM-IV criteria were first met. Machine PGs (n = 25) had a significantly shorter latency of onset than did traditional PGs (1.08 years vs. 3.58 years). Females and machine PGs had a significantly older age of onset, but gender was not associated with latency of PG-onset. Lifetime comorbidity of either substance use disorders (SUDS) or depressive disorders (DDS) was also not associated with the latency of PG-onset. The results of the current study suggest that intrapersonal variables such as gender and comorbid disorders do not generally affect the speed with which people develop PG. Rather, the social, environmental, and stimulus features of mechanized gambling are implicated. Prospective longitudinal studies on the onset and course of PG are needed, as well as more basic research on the features of machine gambling that may contribute to rapid onset.     

Gift Giving, Identity, and Transformation: The AIDS Memorial Quilt

Those who have originated the AIDS Memorial Quilt have often referred to it as a gift. In this essay, the author discusses theories related to gift giving to discuss the quilt and its constructed effects for those who experience it as a gift. In particular, Weiner's notion of inalienable possessions is highlighted to address how the quilt, as a gift that is kept inalienable from its original creators, maintains historical identity and immortality for its originators, many of whom are gay and bisexual men. Also, Hyde's notion of erotic gifts is presented to consider the quilt's ability to draw people together, create feeling-bonds among them, and affect their transformation.     

Neutralizing marginally deviant behavior: Bingo players and superstition

Bingo is one of the most popular and most accepted forms of gambling in the United States today. Yet, despite its popularity, many bingo players are not completely comfortable with the moral rightness of their actions. This participant observation and interview study spanning a 5 year period shows how bingo players use superstitious strategies, such as feelings, hunches and psi, attitudes, and luck to neutralize their marginally deviant behaviors.     

Play grounds

The author discusses the ambience presented by casinos to their customers. He explores the issues of space as an attraction to people being brought into casinos for the purpose of play and the compatibility of the casino's internal design with the concept of welcoming space and its degree of legibility: how well a first time visitor can read the activities and opportunities within its spaces.     

Gambling swindles and victims

This article focuses on clever confidence schemes designed for gambling swindles. Victims of these schemes are sought out for their character and investment potential by con men working together. The big con schemes involve considerable planning and time in order to beat a carefully selected, wealthy victim; perhaps in a simulated casino setting. In contrast, the short con scheme may be carried out by a team or mob using a suburban street corner, or at a traveling carnival. Gaffed (rigged) game equipment may be used along with proven methods, and a well-rehearsed story or pitch by the operators.Until his recent retirement, Robert J. Snyder served as a career law enforcement officer for one of the largest policing agencies in the United States. The focus of his career was on gaming and gambling, especially carnival games and confidence schemes.Mr. Snyder also participates in training law enforcement officers and in providing expert witness testimony for court proceed ings on carnival and gambling confidence schemes. He currently heads Bob Snyder and Associates, Inc., a consulting firm based in Los Angeles, specializing in Gaming/Gambling issues for governmental agencies and private industry.