Gambling and the family: From the stress‐coping‐support Perspective 1

Abstract

Aims: To apply the stress‐coping‐support perspective to the study of the effects of problem gambling in the family. Specifically, to examine the ways in which family members cope and the nature and sources of support they receive. To compare coping strategies of family members of gamblers with those of individuals living with other addictive behaviour in the family. Design: Cross‐sectional interview and questionnaire study of close relatives of problem gamblers. Participants: Sixteen close family members of gamblers from separate families, mainly parents and partners. Data: Semi‐structured interview; adapted version of the Coping Questionnaire (CQ). Findings: Data from the CQ and qualitative analysis of interview data suggested considerable use of ‘engaged’ (specifically controlling) ways of attempting to cope with such problems, comparable to the use of such strategies by relatives of people with alcohol or drug problems, but little use of ‘tolerant‐accepting’ and ‘withdrawal’ ways. Interview data on the support received (or not) by family members confirmed previous research showing that relatives of people with addiction problems often feel unsupported, but particularly appreciate positive emotional and practical support for themselves and their problem gambling relatives. Conclusions: The stress‐coping‐support perspective, previously applied to families with alcohol and drug problems, also offers an appropriate framework for understanding problem gambling and the family.     

Does the General Strain Theory Explain Gambling and Substance Use?

General Strain Theory (GST: Agnew Criminology 30:47–87, 1992) posits that deviant behaviour results from adaptation to strain and the consequent negative emotions. Empirical research on GST has mainly focused on aggressive behaviours, while only few research studies have considered alternative manifestations of deviance, like substance use and gambling. The aim of the present study is to test the ability of GST to explain gambling behaviours and substance use. Also, the role of family in promoting the adoption of gambling and substance use as coping strategies was verified. Data from 266 families with in mean 8 observations for each group were collected. The multilevel nature of the data was verified before appropriate model construction. The clustered nature of gambling data was analysed by a two-level Hierarchical Linear Model while substance use was analysed by Multivariate Linear Model. Results confirmed the effect of strain on gambling and substance use while the positive effect of depressive emotions on these behaviours was not supported. Also, the impact of family on the individual tendency to engage in addictive behaviours was confirmed only for gambling.     

Maladaptive Coping as a Mediator of Family Stress

Family members of women substance users may be at risk for stress-related problems. Family coping responses may affect outcomes for both families and women in treatment. Eighty-two women in treatment for substance use disorders (56 with comorbid psychiatric conditions) and 82 family members were interviewed. Stressors related to women's disorders were significantly related to increased family member burden. Women's behavioral problems predicted greater family member Worry, Displeasure, and Impact. Extent of women's drug or alcohol use predicted greater family member Stigma and Impact. Family member maladaptive coping partially mediated relationships between family member stressors and family member Displeasure and Impact. Family member maladaptive coping also functioned as a moderator between the stressors and Impact.     

A typical problem gambler affects six others

While the financial and psychological burden on problem gamblers can be severe, at least some of the ill effects are also passed on to family or other close social ties. The present study estimated the number of affected-others for the typical problem gambler. Australian members of an online panel with gambling problems (N = 3076) and panel members who indicated that they had been affected by someone else’s gambling (N = 2129) were asked to estimate the number of other people who were negatively affected by their gambling. Using robust statistics to analyse this data, the study found lower estimates made by problem gamblers (four affected people) compared to estimates made by affected others (six affected people, including the respondent). It was concluded that a point-estimate of six people affected is a more accurate figure since it does not suffer from self-presentation effects of problem gamblers. Low-risk and moderate-risk gamblers, unsurprisingly, affected far fewer other people (one and three, respectively). Both gamblers and affected-others most often identified close family members, including spouses and children, as the people impacted by others’ gambling problems. These results provide an approximate measure of the number of people affected, per problem gambler, to facilitate accurate accounting of the harms accruing from gambling problems.     

Compulsive gambling: Structured family intervention

Family intervention has been an effective procedure for getting alcoholics into treatment for more than twenty years. Now this technique is being used with compulsive gamblers. Because the gambling disorder is so easy to hide, the patient seems to be further into the illness by the time the family seeks help. Furthermore, because the gambling offers intermittent rewards, the denial in both the patient and family appears to be stronger than found with most alcoholics.During the intervention it is important to tell the compulsive gambler why the help of a professional was sought; what changes have been observed by family members and friends as a result of his/her gambling; how family relationships have been affected; what is feared will happen if he/she doesn't get help; and what each family member hopes will happen once the gambler is in recovery.Most concerned persons enter family interventions with the sole purpose of getting the gambler into treatment. However, since this is a family disease, ethically the primary goal of family intervention needs to be to getsomeone into treatment, if not the individual suffering with the disease then one or more of those concerned persons suffering from it.     

Injunctive Norms and Problem Gambling among College Students

Two studies examined the relationships among injunctive norms and college student gambling. In study 1 we evaluated the accuracy of perceptions of other students’ approval of gambling and the relationship between perceived approval and gambling behavior. In study 2 we evaluated gambling behavior as a function of perceptions of approval of other students, friends, and family. In study 1, which included 2524 college students, perceptions of other students’ approval of gambling were found to be overestimated and were negatively associated with gambling behavior. The results of study 2, which included 565 college students, replicated the findings of study 1 and revealed positive associations between gambling behavior and perceived approval of friends and family. Results highlight the complexity of injunctive norms and the importance of considering the reference group (e.g., peers, friends, family members) in their evaluation. Results also encourage caution in considering the incorporation of injunctive norms in prevention and intervention approaches.     

A Latent Class Analysis of Gambling Activity Patterns in a Canadian University Sample of Emerging Adults: Socio-demographic,Motivational, and Mental Health Correlates

This analysis of gambling habits of Canadian university students (ages 18–25) dovetails two recent developments in the field of gambling studies. First, the popularity of latent class analysis to identify heterogeneous classes of gambling patterns in different populations; second, the validation of the Gambling Motives Questionnaire (with financial motives) among university students—specifically to understand both how and why emerging adults gamble. Our results support a four-class model of gambling activity patterns, consisting of female-preponderant casual and chance-based gambling groups, and male-preponderant skill-based and extensive gambling groups. Each class shows a specific combination of motives, underscoring the necessity for nuanced responses to problem gambling among emerging adults. More specifically, gambling for the skill-based group appears primarily to be a source of thrill and a way to cope; for the chance-based group, gambling appears but one symptom of a set of wider issues involving depression, anxiety, substance use, and low self-esteem; while extensive gamblers seem to seek excitement, sociality, and coping, in that order. Only the chance-based group was significantly more likely than casual gamblers to be motivated by financial reasons. Situating our analysis in the literature, we suggest that interventions for the predominantly male subtypes should address gambling directly (e.g. re-focusing excitement seeking into other activities, instilling more productive coping mechanisms) while interventions for predominantly female subtypes should address low self-esteem in conjunction with depression, substance abuse, and problematic levels of gambling. We conclude future research should focus on links between self-esteem, depression, substance abuse, and financial motives for gambling among female emerging adults.     

Does Family Intervention for Adolescent Substance Use Impact Parental Wellbeing? A Longitudinal Evaluation

Adolescent substance abuse is a common problem and family interventions are emerging as a strategy to prevent it and assist family coping. The effectiveness of a prevention‐focussed family intervention was evaluated for its secondary impacts on improving parental mental health and family functioning. Twenty‐four secondary schools in Melbourne Victoria were randomly assigned to either a control condition or an intervention titled Resilient Families. The two intervention levels analysed were: (1) a parenting booklet only and; (2) combining the booklet with face‐to‐face parent education sessions. Parent surveys at baseline were followed up one year and four years later. Repeated‐measures analysis (n = 560) found parents attending parent education demonstrated reductions in mental health symptoms, however this had negative effects on family cohesion and no impact on family conflict. These findings were interpreted in terms of parent education assisting parent mental health by promoting assertive parenting styles that may increase adolescent‐parent tension by encouraging firmer parental boundaries and strategies to reduce adolescent substance use.     

Treating Chronic Crisis Bearers and Their Families*

This article presents a method for family crisis intervention, utilizing a case history approach. The goal is extended from restoring the crisis bearing unit to its pre-crisis level of coping to a basic restructuring of maladaptive pre-crisis behaviors. It is aimed at general behavior change as well as resolution of the immediate situation. It adapts crisis intervention theory to intervention involving chronic crisis bearers and their families. It eliminates the tendency to identify one member of the family unit as the patient without considering the impact of the other members. This approach consists of short term intensive treatment combined with selected traditional techniques.     

Economic mobility moderates the effect of relative deprivation on financial gambling motives and disordered gambling

This study examined whether a positive association between personal relative deprivation and disordered gambling severity is mediated by the motivation to gamble for financial gain. We hypothesized that this would occur specifically among people who perceived a low personal capacity for upward economic mobility via conventional means of advancement. A sample of community gamblers (N = 196) completed measures of personal relative deprivation, perceptions about upward economic mobility, gambling motivations (financial, coping, enhancement and social) and disordered gambling severity. The predicted moderated mediation model was observed – among people who perceived a low capacity for upward economic mobility, relative deprivation predicted disordered gambling severity via the motivation to gamble for financial gain. This indirect effect did not hold among people who perceived a high capacity for upward mobility. These findings suggest the importance of addressing beliefs about upward economic mobility in gambling prevention and intervention strategies. Among gamblers who feel relatively deprived, it may be advantageous to highlight feasible avenues for upward economic mobility that do not involve gambling.     

Latent Class Analysis of Gambling Activities in a Sample of Young Swiss Men: Association with Gambling Problems,Substance Use Outcomes,Personality Traits and Coping Strategies

The study aimed to identify different patterns of gambling activities (PGAs) and to investigate how PGAs differed in gambling problems, substance use outcomes, personality traits and coping strategies. A representative sample of 4989 young Swiss males completed a questionnaire assessing seven distinct gambling activities, gambling problems, substance use outcomes, personality traits and coping strategies. PGAs were identified using latent class analysis (LCA). Differences between PGAs in gambling and substance use outcomes, personality traits and coping strategies were tested. LCA identified six different PGAs. With regard to gambling and substance use outcomes, the three most problematic PGAs were extensive gamblers, followed by private gamblers, and electronic lottery and casino gamblers, respectively. By contrast, the three least detrimental PGAs were rare or non-gamblers, lottery only gamblers and casino gamblers. With regard to personality traits, compared with rare or non-gamblers, private and casino gamblers reported higher levels of sensation seeking. Electronic lottery and casino gamblers, private gamblers and extensive gamblers had higher levels of aggression-hostility. Extensive and casino gamblers reported higher levels of sociability, whereas casino gamblers reported lower levels of anxiety–neuroticism. Extensive gamblers used more maladaptive and less adaptive coping strategies than other groups. Results suggest that gambling is not a homogeneous activity since different types of gamblers exist according to the PGA they are engaged in. Extensive gamblers, electronic and casino gamblers and private gamblers may have the most problematic PGAs. Personality traits and coping skills may predispose individuals to PGAs associated with more or less negative outcomes.     

Females' Coping Styles and Control Over Poker Machine Gambling

An investigation of the relationship between impaired control over gambling, coping strategies, and demographic variables was conducted by surveying female poker machine players (N = 163) in their gaming venues. Metropolitan (n = 14) and regional (n = 6) gaming venues in Victoria, Australia participated. Control over gambling was measured using the Impaired Control Over Gambling Scale (Baron & Dickerson, 1994). Coping strategies were measured using (Folkman et al., 1986) adaptation of the Revised Ways of Coping Checklist (Vitaliano et al., 1985). MANOVA supported the hypothesis that the lower the control over gambling the greater the reliance on emotion-focused coping (blamed self, wishful thinking, avoidance) with F = 9.92, 13.35, 14.04 respectively, all significant at p < .001. MANOVA failed to supported the hypothesis that problem-focused strategies (problem focus, seek social support) would be significantly related to control over gambling with F = .82 and .21 respectively. Control over gambling was not related to age, employment, relationship status, education, ordistress from significant life events, further supporting the relationship between control and coping strategies. Ways in which coping styles might be related to pathological gambling are discussed.     

Mindfulness in Patients With Gambling Disorders

This study explored facets of mindfulness between patients diagnosed with a gambling disorder (n = 26) and a community sample of non-gambling-disordered individuals (n = 33). Multivariate statistics comparing group differences showed the gambling-disordered patients exhibited significantly lower levels of mindfulness, emotional regulation, stress coping, and impulse control compared to the non-gambling-disordered group. Overall, gambling severity was negatively associated with higher levels of mindfulness and positively linked to indices of emotional dysregulation, stress proneness, and impulsivity. Correlations between mindfulness and emotional dysregulation and impulsivity were much stronger than those between mindfulness and the severity of disordered gambling behaviors as measured by the National Opinion Research Center DSM Screen for Gambling Problems (NODS). These findings are discussed in the context of possible implications for future directions in exploring mindfulness-based interventions as a plausible intervention among those with gambling disorders.     

Coping with Guilt and Shame After Gambling Loss

In this study we examined the relations between guilt and shame and coping strategies in response to gambling loss. Based on H.B. Lewis’s (Shame & guilt in neurosis. New York: International Universities Press, 1971) account of guilt and shame, we proposed that unlike guilt, the experience of shame involves the attribution of gambling loss to stable and global internal factors (i.e., self-devaluation). We hypothesized that problem gambling severity would be more strongly associated with the intensity of shame than with the intensity of guilt following gambling loss. Further, we hypothesized that the intensity of shame would be positively associated with the use of avoidant coping strategies following gambling loss. Finally, we hypothesized that the intensity of shame would mediate the association between problem gambling severity and the use of avoidant coping. These hypotheses were supported by a retrospective survey of recent gambling losses. Our finding suggests that the experience of shame and the use of avoidant coping strategies to deal with this emotion are central to problem gambling severity.     

Personality,Gender, and Family History in the Prediction of College Gambling

The present study examined the degree to which gambling behaviors and gambling-relevant cognitive distortions could be predicted by personality factors, gender, and familial history of substance use and gambling problems in a large sample of college students (N = 581). Results indicate that parental gambling problems and, especially for males, a propensity to experience negative emotions predicted time spent gambling and gambling problems. Negative emotionality, along with parental substance use problems, impulsivity, and being male predicted gambling-related cognitive distortions. The differing pattern for impulsivity with respect to behaviors and beliefs might be explained by the low accessibility of gambling venues for the student population. We compare the present findings with past studies examining gambling behaviors in adult populations.     

A Comparison of Depression and Styles of Coping in Male and Female GA Members and Controls

Depression and maladaptive coping styles are important components of theories of pathological gambling and are frequently foci of treatment with individuals with gambling problems. The present study aimed to improve understanding and treatment of pathological gambling by comparing levels of depression and styles of coping in male and female members of Gamblers Anonymous (GA) to a group of non-pathological gambling controls matched according to gender, age, education, and income. Pathological gambling was measured by the South Oaks Gambling Scale, depression by the Beck Depression Inventory, and coping styles by the Problem-Focused Styles of Coping inventory. Results showed that GA members reported significantly higher levels of depression and more maladaptive styles of coping than controls. Pathological gamblers' greater use of maladaptive coping was evident even when variance attributable to depression was removed, suggesting that their coping deficits may be pervasive. Female subjects reported significantly greater levels of depression and maladaptive coping thantheir male counterparts. Implications for treating depression and coping styles in pathological gamblers are discussed.     

Assessing the differential impacts of online,mixed, and offline gambling

The emergence of new behaviours associated with communication technologies has prompted questions about the evolution of gambling in the population. The development of online gambling gave rise to public health concerns back 20 years ago. Current knowledge indicates that online gamblers generally tend to show more psychosocial problems than offline gamblers. But those portraits tend to neglect the differences between pure and mixed online gamblers. The goal of this research is to assess if, and to what extent, online gambling generates more harmful impacts on the health and well-being in a sample of adult gamblers in Québec. The propensity score matching method was chosen to assess the variable prevalence of impacts on a sample of 810 regular gamblers recruited from an online panel. They were divided into sub-groups: pure online gamblers (n = 143), mixed online gamblers (n = 125), and a control group of offline gamblers (n = 542). The study has revealed that among online gamblers and their entourage, online gambling does, in fact, result in an extra burden of impacts in several aspects of their lives: work, relationships, mental/physical health, finances, quality of life, and problem gambling according to the Canadian Problem Gambling Index. Results also show that combined with offline gambling, online gambling significantly increases the burden of impacts in terms of both the number and intensity of impacts. This is the first empirical study using propensity score matching to asses the incremental impacts of online gambling by separating pure and mixed gamblers and to compare them to offline gamblers.     

Adolescent Gambling and Coping within a Generalized High-risk Behavior Framework

Data were collected for 1998 middle/high-school students in Ontario to assess involvement in gambling, substance use, and generalized risky behavior. To predict these outcomes, measures for anxiety, family cohesion, and coping style were also administered. Three a-priori models were posited to account for the impact of risk factors, protective factors, and combined risk/protective factors on the development of risky behaviors. A high-risk cohort composed of subjects endorsing at least one risky behavior (gambling, substance use, or generalized risky behavior) within the clinical range was created to test an unobserved outcome variable created from all three measures of risky behavior, which was successfully predicted by two of the three a-priori models. Implications for the inclusion of gambling within a constellation of high-risk behaviors and recommendations for future prevention efforts are discussed. Electronic supplementary material The online version of this article (doi:) contains supplementary material, which is available to authorized users.     

Associations between gambling,substance misuse and recidivism among Canadian offenders: a multifaceted exploration of poor impulse control traits and behaviours

Moderate correlations among gambling, substance use and crime suggest these three behaviours may each be indicators of a single underlying problem trait, such as poor impulse control. We tested whether self-reported traits prospectively predicted future criminal recidivism, when accounting for incarcerated adult offenders' past criminal behaviour, substance use and gambling behaviour. We took a multi-construct approach to measuring components of impulse control, utilizing three questionnaires that assess sensation seeking, poor premeditation, and reward sensitivity. Male participants incarcerated in two federal institutions were invited to complete self-report booklets; participation was self-selected and fully voluntary. Results indicated moderate correlations between measures of trait impulse control, self-reported drug use, and official criminal history (N = 140). Gambling problems prospectively predicted post-release criminal recidivism (n = 83), even when accounting for past criminal behaviour, impulse control traits and substance misuse. Although they represent a small percentage of this sample, results suggest offenders with high gambling problems represent a particularly at-risk group for future crime, who were more than four times likely to reoffend compared to offenders without problem gambling. These results suggest there may be mutual impact of problem behaviours on life outcomes above the contribution of poor impulse control.     

‘Let's Talk About Children’: Investigating the Use of a Family‐focused Intervention in the Gambling Support Services Sector

The family‐focused mental health intervention, ‘Let's Talk About Children,’ has positively influenced the lives of families affected by parental mental illness. This paper outlines the use of this brief, strengths‐based intervention for parents with gambling and other co‐occurring issues from the gamblers’ support services sector. Over a six‐month period, a training manual and accompanying resources were adapted for the gamblers’ support services sector and a targeted training session developed. Nine problem gambling counsellors from three Victorian gambling support services trialled the Let's Talk About Children intervention over a four‐month period. Qualitative data were gathered through focus groups, interviews, and practice enquiry groups to determine the impact of the Let's Talk About Children model for gambling support services. The results are presented as ‘practice wisdoms and recommendations’ reporting on the impact of the trial and to provide some guidance to support others in the implementation of a specific family‐focused intervention. This paper reports on the first exploratory trial of Let's Talk About Children for the gambler's support services sector in Australia.