Defining a threshold of harm from gambling for population health surveillance research

The measurement of harm in the context of non-problem gambling has received little attention from researchers in the field. Using the combined data from six provincial gambling surveys conducted in Canada between 2001 and 2005 (N = 12,285), we compared how different thresholds of defining gambling-related harm impacts prevalence, the relationship with indicators of gambling intensity and the characteristics of non-pathological gamblers who report experiencing below threshold symptoms of problem gambling. Survey items defining harm were drawn from the Problem Gambling Severity Index (PGSI) of the Canadian Problem Gambling Index. Three definitions of harm – reporting one or more problem gambling symptoms, reporting two or more problem gambling symptoms and having a PGSI score ≥ 3 – demonstrated a strong relationship with indicators of gambling intensity, and reliably differentiated low-threshold and zero symptom problem gamblers in terms of gambling characteristics and other risk factors.     

Problem Gambling Inside and Out: The Assessment of Community and Institutional Problem Gambling in the Canadian Correctional System

This paper reports on the results of a multi-site survey of gambling behaviour and gambling problems amongst offenders in correctional institutions in Ontario, Canada, conducted between 2008 and 2011. A total of 422 (completion rate 61.5 %) incarcerated offenders (381 male and 41 female) took part in the study including 301 federal offenders and 121 provincial offenders. Based on the Problem Gambling Severity Index of the Canadian Problem Gambling Index (CPGI/PGSI) the prevalence rate of severe problem gambling was 8.9 prior to incarceration and 4.4 % during incarceration. These numbers are substantially higher than rates found among the general public. Thirty-four percent of the sample reported gambling in prison. Half of those who suffered from gambling problems before incarceration continued to have gambling problems during incarceration. People with problems related to slot machines prior to incarceration reported fewer gambling problems during incarceration compared to other problem gamblers.     

Validation of the Consumption Screen for Problem Gambling (CSPG)

A 3 item screen for problem gambling was developed based on a conceptual analogue of the Alcohol Use Disorders Identification Test—Consumption (Bush et al. in Arch Intern Med 158:1789–1795, 1998); a brief screen that measures consumption rather than harm. Data were collected from an email panel survey of 588 men and 810 women (n = 1,398) across all states in Australia. Respondents indicated their consumption of gambling products using the 3 items of the new Consumption Screen for Problem Gambling (CSPG). Receiver Operating Characteristics curve analysis was used to analyze the performance of the new items relative to the Problem Gambling Severity Index (Ferris and Wynne in The Canadian problem gambling index: Final report, 2001). Results show a 98% probability that the CSPG score for a randomly chosen positive case of problem gambling will exceed the score for a randomly chosen negative case. In addition, a score of 4+ on the CSPG identified all 14 cases of Problem Gambling correctly, while only 7.3% of non-problem gamblers had scores of 4+ (sensitivity = 100%; specificity = 92.7%). Lastly, only 3.0% of respondents without any gambling problems had CSPG scores of 4+. The current study suggests that the CSPG, a brief consumption-based measure for gambling products, can quickly and accurately identify people who are likely to be experiencing gambling problems.     

The Four Es of Problem Gambling: A Psychological Measure of Risk

A focus group of Reno area Gamblers Anonymous members identified four psychological traits contributing to risk for problem gambling, including: Escape, Esteem, Excess and Excitement. A panel of four experts authored 240 Likert-type items to measure these traits. By design, none of the items explicitly referred to gambling activities. Study 1 narrowed the field of useful items by employing a quasi-experimental design which compared the answers of Reno area Gamblers Anonymous members (N = 39) to a control sample (N = 34). Study 2 submitted successful items, plus new items authored with the knowledge gained from Study 1, to validation in a random sample telephone survey across Queensland, Australia (N=2577). The final 40 item Four Es scale (4Es) was reliable (α=.90); predicted gambling problems as measured by the Canadian Problem Gambling Index of Severity (PGSI, Ferris & Wynne (2001). The Canadian Problem Gambling Index: Final Report: Canadian Centre on Substance Abuse); and distinguished problem gamblers from persons with alcohol abuse problems. The new scale can provide a basis for further study in harm minimization, treatment, and theory development.     

Psychometric Evaluation of the Problem Gambling Severity Index-Chinese Version (PGSI-C)

The purpose of this study was to examine the psychometric properties of the Chinese 9-item Problem Gambling Severity Index (PGSI) derived from the 31-item Canadian Problem Gambling Index (CPGI) originally developed by Ferris and Wynne (2001). Exploratory factor analysis (EFA; n = 386; Group A data) and confirmatory factor analysis (CFA; n = 387; Group B data) on the Chinese student and community data (Mean age = 25.36 years) showed that a unifactorial model fitted the data with good reliability score (Cronbach’s alpha = 0.77). The concurrent validity of the PGSI-C was good in terms of the Chinese data matching the expected correlation between PGSI-C and other variables or scales such as SOGS, gambling frequency, gambling urge, gambling cognitions, depression, anxiety, and stress. The scale also reported good discriminant and predictive validity. In sum, the PGSI-C has good psychometric properties and can be used among Chinese communities to identify at-risk problem gamblers. Implications and suggestions for future research are discussed.     

Dimensions of Problem Gambling Behavior Associated with Purchasing Sports Lottery

The purpose of this study was to identify and examine the dimensions of problem gambling behaviors associated with purchasing sports lottery in China. This was accomplished through the development and validation of the Scale of Assessing Problem Gambling (SAPG). The SAPG was initially developed through a comprehensive qualitative research process. Research participants (N = 4,982) were Chinese residents who had purchased sports lottery tickets, who responded to a survey packet, representing a response rate of 91.4%. Data were split into two halves, one for conducting an EFA and the other for a CFA. A five-factor model with 19 items (Social Consequence, Financial Consequence, Harmful Behavior, Compulsive Disorder, and Depression Sign) showed good measurement properties to assess problem gambling of sports lottery consumers in China, including good fit to the data (RMSEA = 0.050, TLI = 0.978, and CFI = 0.922), convergent and discriminate validity, and reliability. Regression analyses revealed that except for Depression Sign, the SAPG factors were significantly (P < 0.05) predictive of purchase behaviors of sports lottery. This study represents an initial effort to understand the dimensions of problem gambling associated with Chinese sports lottery. The developed scale may be adopted by researchers and practitioners to examine problem gambling behaviors and develop effective prevention and intervention procedures based on tangible evidence.     

Venue Staff Knowledge of Their Patrons’ Gambling and Problem Gambling

In several jurisdictions around the world, venue staff are encouraged to make reasonable attempts to determine whether patrons may be experiencing problems associated with their gambling. Although a number of visible indicators and behaviours are recognised as being indicative of gambling problems, no research has investigated how effective staff might be in identifying problem gamblers in venues. The aim of this field test was to examine the level of patron familiarity amongst staff working in small to moderate-sized venues. Patrons (n = 303) were asked to complete a short survey including the Problem Gambling Severity Index and venue staff were asked to describe their knowledge of the same patrons independently. The results showed that patrons rated as more at risk by staff scored significantly higher on the PGSI, but that point-in-time staff ratings were not sufficiently accurate to allow effective identification of problem gamblers. The importance of using accumulated information over multiple sessions as well as technological monitoring of behaviour was emphasised by these results.     

Differences in Cognitive Distortions Between Pathological and Non-Pathological Gamblers with Preferences for Chance or Skill Games

Cognitive distortions have been thought to play an important role in the development and maintenance of pathological gambling. The present study investigated whether severity of gambling problems and gamblers’ preference for chance or skill games were related to two sub-factors of cognitive distortions as measured by the Gamblers Belief Questionnaire: Luck/Perseverance, which reflects an individual’s perception that chance is favorable to him/her, and Illusion of Control, which reflects an individual’s perception that his/her behavior influences chance occurrences. Participants (N = 166) were recruited from a race track (n = 79), off-course betting facilities (n = 50) and from an online treatment program for problem gamblers (n = 49). Gambling severity was measured by the South Oaks Gambling Screen, and 73 were classified as pathological gamblers whereas 93 were classified as non-pathological gamblers. The present study supports previous proposals that cognitive distortions are core processes related to gambling behavior as pathological gamblers reported more cognitive distortions than did non-pathological gamblers. A preference for skill games was also associated with greater Illusion of Control compared to a preference for chance games. For gamblers preferring skill games there were no differences in Luck/Perseverance or Illusion of Control between pathological and non-pathological gamblers.     

The Self-Regulation of Gambling

Despite the prevalence of gambling world-wide, relatively few individuals become problem gamblers. Additionally many problem gamblers recover without professional assistance. The current study aim was to examine how individuals self-manage their gambling through (a) assessing frequency of use of a range of self-regulation strategies (b) examining how these strategies cluster and (c) exploring relationships between strategies, gambling frequency, amount spent and problem gambling severity. A sample of 303 gamblers was recruited, over-sampling for problem gamblers as assessed by the Problem Gambling Severity Index (PGSI) of the Canadian Problem Gambling Index (mean age 26.4 years, SD = 10.1 years; 119 males, 184 females; 238 social gamblers, 63 problem gamblers, 2 unclassified). They rated extent of usage of 27 gambling self-management techniques and completed the PGSI and other gambling measures. Factor analysis of items produced five factors, named Cognitive Approaches, Direct Action, Social Experience, Avoidance and Limit Setting. The relationships between these factors and key gambling variables were consistent with hypotheses that problem gamblers trying to reduce their gambling would be more likely to use the strategies than other gambler groups. The potential for developing the factors into a Gambling Self-regulation Measure was explored.     

Poker Mania and Problem Gambling: A Study of Distorted Cognitions,Motivation and Alexithymia

This study examines the relationships between distorted cognitions, motivation, and alexithymia on problem gambling in poker players (n = 96). Respondents completed questionnaires containing the Canadian Problem Gambling Index, Gambling Motivation Scale, Gambler’s Beliefs Questionnaire, and Toronto Alexithymia Scale-20. The results suggest that problem gambling is significantly related to distorted cognitions, non-self-determined motivation, and difficulty identifying feelings. Implications are drawn for the development of more relevant intervention, prevention, and treatment strategies.     

Gambling Related Cognitions Mediate the Association Between Thinking Style and Problem Gambling Severity

This study examined the associations among thinking style (rational versus experiential), gambling related cognitions, and problem gambling severity. The participants were 70 female and 41 male regular gamblers who completed the Gambling Related Cognitions Scale (Raylu and Oei, Addiction 99:757–769, 2004), the Rational-Experiential Inventory (Pacini and Epstien, J Pers Soc Psychol 76(6):972–987, 1999), and the Problem Gambling Severity Index (Ferris and Wynne, The Canadian problem and gambling index: final report. Canadian Centre on Substance Abuse, Ottawa, 2001). Rational thinking was negatively related to problem gambling severity. Gambling related biases increased with problem gambling severity but the strength of those biases was dampened by rational thought. The patterns by which gambling related cognition mediated the association between thinking style and gambling severity suggest that therapeutic interventions may benefit from a consideration of a gambler’s thinking style.     

The Desire to Gamble: The Influence of Outcomes on the Priming Effects of a Gambling Episode

The influence of gambling outcomes on the efficacy of a short gambling episode to prime motivation to continue gambling was determined in two experiments in which desire to gamble was evaluated while participants played a slot machine located in a virtual reality casino. In experiment 1, 38 high-risk [>3 Problem Gambling Severity Index (PGSI)] [Ferris and Wynne (The Canadian problem gambling index: final report, 2001)] and 36 non-problem gamblers (0 PGSI) either won or lost a modest amount. Among high-risk gamblers, winning resulted in a greater increase in the desire to continue gambling than did losing. In experiment 2, 39 high-risk, 33 low-risk (0 < PGSI < 3), and 31 non-problem gamblers experienced either a single large win or a series of small wins (equivalent monetary gain). Participants were permitted to continue playing as long as they wanted (all subsequent spins being losses) thus permitting evaluation of persistence (resistance to extinction). Throughout, desire to gamble was assessed using a single item measure. High-risk gamblers who experienced a large win reported significantly greater desire to gamble upon voluntary cessation than those who experienced a series of small wins. It seems that the priming effects of a short gambling episode are contingent on the pattern of outcomes experienced by the gambler. The data were related to motivational factors associated with gambling, gambling persistence, and chasing losses.     

Development and Psychometric Evaluation of a 10-Item Short Form Inventory of Gambling Situations

The Inventory of Gambling Situations (IGS-63; Turner and Littman-Sharp, Inventory of gambling situations users guide, 2006) is a 63-item measure of high-risk gambling situations. It assesses gambling across 10 situational subscales that load onto two higher-order factors: negative and positive situations (Stewart et al. Psychology of Addictive Behaviors, 22:257–268, 2008). While the IGS-63 has excellent psychometric properties (Littman-Sharp et al., The Inventory of Gambling Situations: Reliability, factor structure, and validity (IGS Technical Manual), in press) its length may preclude its use in time-limited contexts. The purpose of this study was to develop and validate a 10-item short-form of the IGS (IGS-10). Each IGS-10 item reflects one of the ten subscale categories from the IGS-63, with two items from the original subscales included as examples for each IGS-10 item. The IGS-10 was administered to 180 undergraduate gamblers along with the IGS-63 and the Problem Gambling Severity Index (PGSI; Ferris and Wynne, Canadian Problem Gambling Index: Final report, 2001). IGS-10 items showed convergent validity with the corresponding IGS-63 subscales (r’s = .60–.73). Principal components analysis of the IGS-10 revealed two factors: negative (α = .84) and positive (α = .85). PGSI scores correlated significantly with all IGS-10 items (r’s = .33–.58) and with both IGS-10 higher-order subscales (r’s = .66 [negative] and .49 [positive]), supporting the criterion validity of the IGS-10. Since minimal information is lost when using the IGS-10, the short form may prove particularly useful when respondent burden prevents using the full IGS-63.     

Beliefs About Gambling Problems and Recovery: Results from a General Population Telephone Survey

Respondents were asked their beliefs about gambling abuse as part of a general population telephone survey. The random digit dialing survey consisted of 8,467 interviews of adults, 18 years and older, from Ontario, Canada (45% male; mean age = 46.2). The predominant conception of gambling abuse was that of an addiction, similar to drug addiction. More than half of respondents reported that treatment was necessary and almost three-quarters of respondents felt that problem gamblers would have to give up gambling completely in order to overcome their gambling problem. Problem gamblers (past or current) were less likely than non- or social gamblers to believe that treatment was needed, and current problem gamblers were least likely to believe that abstinence was required, as compared to all other respondents. Strong agreement with conceptions of gambling abuse as disease or addiction were positively associated with belief that treatment is needed, while strong agreement with conceptions of disease or wrongdoing were positively associated with belief that abstinence is required.     

Impulsivity,compulsivity and pathological gambling: an exploratory study of pathological gambling as an impulsivity-compulsivity spectrum disorder

The current study was conducted to examine pathological gambling as an impulsivity-compulsivity spectrum disorder. University students (N=162) who gambled a minimum of twice monthly completed measures of impulsivity, compulsivity and pathological gambling. Instruments completed included: measures of problem gambling severity (South Oaks Gambling Screen, NORC DSM-IV Screen for Gambling Problems, Canadian Problem Gambling Index, Victorian Gambling Screen), the Padua Inventory, the Barratt Impulsivity Scale and the Tridimensional Personality Questionnaire. Results supported previous research indicating that pathological gamblers had elevated scores on measures of impulsivity and compulsivity, as well as personality factors correlated with these two constructs. Moreover, impulsivity and compulsivity were found to be interrelated as proposed by the impulsivity-compulsivity spectrum model.     

The Impact of Social Desirability Biases on Self-Report Among College Student and Problem Gamblers

The impacts of two types of social desirability bias, self-deceptive enhancement (SDE) and impression management (IM), were examined on self-reports of gambling problems, measured by the South Oaks Gambling Screen (SOGS), and recent gambling behavior, as measured by the Timeline Followback (TLFB) method, in a sample of college students (N = 191), and a sample of treatment-seeking problem gamblers (N = 49). Consistent with our expectations, IM was negatively associated with SOGS scores in both samples. IM was most highly correlated with SOGS scores among treatment-seeking participants (r = −.44, p < .01). Substantial numbers of participants in both samples had high enough IM scores as to call into question the validity of their self-report gambling data, according to published interpretive guidelines. With respect to SDE, we had predicted that it would be positively related to gambling behaviors and gambling-related problems, but found that SDE was inversely related to SOGS scores in both samples. Very little evidence was found for social desirability effects on TLFB scores. Thus, preliminary evidence was obtained that self-report data on gambling problems, but not on gambling behavior (frequency of gambling and amount of time and money spent), may be susceptible to the effects of impression management in both college students and treatment-seeking gamblers.     

Complex Factors and Behaviors in the Gambling Population of Italy

Gambling has seen significant growth globally, and particularly in Italy: it has rapidly evolved from a simple recreational activity to represent 4% of Italian GDP in 2010.A sample of 4.494 gamblers was drawn from IPSAD-Italia^®2007-2008 (Italian Population Survey on Alcohol and Drugs) in order to examine different gambling patterns (assessed using the Canadian Problem Gambling Index Short form scale).Separate analysis was performed on young adults, age 15–24 (n = 1,241; male 56.2%), and adults, age 25–64 (n = 3,253; male 53.8%): compared with adults, Italian youth, although they gambled less (35.7% vs. 45.3%), appeared to have higher prevalence of low risk gambling (6.9% vs. 5.8%) and moderate risk or problem gambling (2.3% vs. 2.2%). Males are more likely to be moderate-risk or problem gamblers. Those with only a primary education are more likely to be moderate-risk or problem gamblers (young adults: RRR = 5.22; adults: RRR = 3.23) than those with a university education, just like those youth who use depressants, but only among younger (RRR = 3.38).A fundamental issue, “do not disapprove of gambling”, seems to relate to problematic gambling: a specific Italian legislation, the Abruzzi Decree Law, could have influenced the perception that gambling may contribute positively to provide additional funds to the government for social good as well as to add needed jobs. Regardless of such potential social benefits, gambling is a social epidemic and if this association should be confirmed by more focused studies, policy makers should evaluate ways to affect this perception as soon as possible.     

Characteristics of Older Adult Problem Gamblers Calling a Gambling Helpline

Background Few investigations have characterized groups of older adults with gambling problems, and published reports are currently limited by small samples of older adult problem gamblers. Gambling helplines represent a widespread mechanism for assisting problem gamblers to move into treatment settings. Given data from older adult problem gamblers in treatment, we hypothesized that older as compared with younger adult problem gamblers calling a gambling helpline would be less likely to report gambling-related problems.Design and methods Logistic regression analyses were performed on data obtained from January 1, 2000 to December 31, 2001, inclusive, from callers with gambling problems (N = 1,084) contacting the Connecticut Council on Problem Gambling Helpline.Results Of the 1,018 phone calls used in the logistic regression analyses, 168 (16.5%) were from older adults and 850 (83.5%) from younger adults. Age-related differences were observed in demographic features, types and patterns of gambling reported as problematic, gambling-related problems and psychiatric symptoms, substance use problems, patterns of indebtedness, and family histories of addictive disorders. Older as compared with younger adult problem gamblers were more likely to report having lower incomes, longer durations of gambling, fewer types of problematic gambling, and problems with casino slot machine gambling and less likely to report gambling-related anxiety, family problems, illegal behaviors and arrests, drug problems, indebtedness to bookies or acquaintances, family histories of drug abuse, and problems with casino table gambling.Conclusions Older as compared with younger adult problem gamblers calling a gambling helpline differ on many clinically relevant features. The findings suggest the need for improved and unique prevention and treatment strategies for older adults with gambling problems.     

SOGS and CGPI: Parallel Comparison on a Diverse Population

The Northern Territory of Australia, one of the most demographically and socially diverse jurisdictions in the country, conducted its first population-based gambling and problem gambling prevalence survey in 2005. Both the South Oaks Gambling Screen (SOGS) and the Canadian Problem Gambling Index (CPGI) were administered to the same sample of respondents. Using data from this survey, the current paper presents a parallel comparison of the respective screens with particular reference to gender, region, and the socio-demographic characteristics of respondents. The respective screens produced significantly different groups of problem gamblers as measured by their association with a range of socio-demographic variables. Specifically, the large number of SOGS items related to money issues may cause selective overrepresentation among low socioeconomic groups, including Indigenous people, who exist in relatively high proportions in the Northern Territory. In addition, there existed substantial gender-based differences within screens. Identified female problem gamblers were associated with household level variables (i.e. employment status, household type and marital status), while males were associated with socio-economic variables including language, education, and income. Further research is required to validate the use of problem gambling screens within the Indigenous population and to understand the role of gender in the experience and categorisation of problem gambling.     

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.