Co-morbidity of gambling and Internet use among Internet and land-based gamblers: classic and network approaches

This study investigated co-morbidity of problem gambling and problematic Internet use (PIU) among adolescent Internet and land-based gamblers, with the classic approach using sum-scores of symptoms and a promising new method, namely the network perspective. This perspective allows testing for how multiple disorders are associated, showing symptoms overlap and centralities. We used cross-sectional data from two population-based samples of adolescents aged 17 years in France (n = 2,240) and Switzerland (n = 944). Measures included Internet gambling, problem gambling and PIU. The classic approach showed that Internet gambling was associated with increased levels of disordered gambling and PIU, but that correlations between disorders were weak (R² min = 3.2%, R² max = 17.6%). The network perspective showed that the co-morbid network of Internet gamblers was more connected in comparison with land-based gamblers. Problem gambling and PIU appeared as separate disorders, but their relationship was increased among Internet gamblers in comparison with land-based gamblers. The network perspective appeared as a promising avenue for a better understanding of addictive disorders, but it should not replace the classic approach, which showed increased levels of addictive behaviours among Internet gamblers.     

Internet Gamblers: A Latent Class Analysis of Their Behaviours and Health Experiences

In order to learn about the behaviours and health experiences of people who gamble on the Internet, we conducted an international online survey with respondents recruited via gambling and gambling-related websites. The mean (SD) age of the 4,125 respondents completing the survey was 35.5 (11.8) years, with 79.1% being male and 68.8% UK residents. Respondents provided demographic details and completed validated psychometric screening instruments for problem gambling, mood disturbances, as well as alcohol and substance misuse, and history of deliberate self harm. We applied latent class analysis to respondents’ patterns of regular online gambling activities, and identified subgroups of individuals who used the Internet to gamble in different ways (L ² = 44.27, bootstrap P = 0.07). We termed the characteristic profiles as ‘non-to-minimal gamblers’; ‘sports bettors’; ‘casino & sports gamblers’; ‘lottery players’; and ‘multi-activity gamblers’. Furthermore, these subgroups of respondents differed on other demographic and psychological dimensions, with significant inter-cluster differences in proportion of individuals scoring above threshold for problem gambling, mood disorders and substance misuse, and history of deliberate self harm (all Χ ²s > 23.4, all P-values <0.001). The ‘casino & sports’ and ‘multi-activity-gamblers’ clusters had the highest prevalence of mental disorder. Internet gamblers appear to be heterogeneous but composed of several subgroups, differing markedly on both demographic and clinical characteristics.     

Gambling and Adverse Life Events Among Urban Adolescents

This study explored the cross sectional association between adverse life events and gambling in a sample of 515 urban adolescents (average age 17, 55% male, 88% African American). Approximately half of the sample had gambled in the past year (51%); 78% of the gamblers gambled monthly and 39% had a gambling-related problem. On the other hand, 88% of the sample had experienced at least one life event in the past year, and those experiencing events tended to live in more disadvantaged neighborhoods. The mere acknowledgement of experiencing a stressful life event in the past year (yes/no) was not associated with an increase in odds of being a gambler, with gambling more frequently, or with having a gambling problem. However, when the context of the event was considered, an association was found between directly experiencing threatening and deviant/violent types of events and frequent gambling (OR > 2). Additionally, the probability of being a gambler increased as the number of events experienced increased (aOR = 1.07, 95% CI = 1.01, 1.13, P = 0.013), but problems among gamblers were not associated with the number of events experienced (aOR = 1.01, 95% CI = 0.92, 1.11, P = 0.876). During adolescence, life events appear to be connected more with the frequency of gambling rather than with problems related to gambling.     

The Prevalence and Types of Gambling Among Undocumented Mexican Immigrants in New York City

Objectives To examine the prevalence of gambling and types of gambling activities in a sample of undocumented Mexican immigrants. Design Non-probability cross-sectional design. Setting New York City. Sample The 431 respondents ranged in age from 18 to 80 (mean age 32), 69.7% were male. Results More than half (53.8%) reported gambling in their lifetime and of those most (43.9%) played scratch and win tickets or the lottery. In multivariate analyses men reported gambling more than women [2.13, 95% CI = (1.03, 4.38)]. The odds of gambling in their lifetime were higher among those reporting sending money to family or friends in the home country [2.65, 95% CI = 1.10, 6.38)], and those who reported 1–5 days as compared to no days of poor mental health in the past 30 days [2.44, 95% CI = 1.22, 4.89)]. Conversely, those who reported entering the U.S. to live after 1996 were less likely to report gambling [0.44, 95% CI = (0.22, 0.89)] as compared to those who had lived in the U.S. longer. Conclusion There is a need to further explore both the prevalence and the severity of gambling amongst the growing population of undocumented Mexican immigrants in the U.S.     

An investigation of problematic internet use among adolescents in terms of self-injurious and risk-taking behavior

The purpose of this study was to examine problematic internet use in terms of self-injurious behavior and risk-taking behavior. This study was performed with 736 high school students, 328 females and 408 males studying at various high schools in Trabzon (in Turkey). The Problematic Internet Use Scale was used to measure students' problematic internet use levels, the inventory of statements about self injury to measure self-injurious behavior and the Adolescent Risk-Taking Questionnaire to measure risk-taking behavior. According to the results of the study, a positive and significant relationship was found between risk-taking behavior and problematic internet use (r = .39, p < 0.01), and it was determined that self-injurious behavior and risk-taking behavior significantly predict problematic internet use (F = 86.94, p < 0.01). Furthermore, it was found that problematic internet use displays variation according to self-injurious behavior (F_{(1, 732)} = 32.32, p < 0.01). The findings have been discussed in relation to the existing literature.     

Disparities in Persistent Victimization and Associated Internalizing Symptoms for Heterosexual Versus Sexual Minority Youth

This study investigated whether lesbian, gay, and bisexual (LGB) adolescents were at higher risk for persistent victimization of bullying compared to heterosexual adolescents, and how victimization trajectories were associated with internalizing symptom development across LGB and heterosexual adolescents. Data came from a five‐wave study (M_ageT1 = 11.1 to M_ageT5 = 22.3; n = 151 LGB; n = 1,275 heterosexual) and informants were adolescents and their parents. Adolescents were classified in three victimization trajectories: persistent (5.6%), decreasing (28.1%) or low (66.3%) victimization. LGB adolescents reported more persistent victimization, relative to no (OR = 6.79, 95% CI [3.52, 13.13]) or decreasing victimization (OR = 3.09, 95% CI [1.53, 6.24]), compared to heterosexual peers. Further, persistent victimization was more strongly associated with anxiety among LGB than among heterosexual adolescents.     

Prevalence of Adolescent Problem Gambling,Related Harms and Help-Seeking Behaviours Among an Australian Population

Epidemiological studies have consistently reported prevalence rates ranging between 0.9 and 23.5% for problem gambling among young people. With such a large range reported in the literature, it is clear that more research in this area would be of value. The current study investigated the prevalence rate of adolescent gambling and problem gambling and explored types of harm-related and help-seeking behaviours associated with gambling specific to this population in an Australian setting. A self-administered battery of questionnaires was distributed to 252 students aged 12–18 years, attending four private schools in the Eastern suburbs of Sydney, Australia. The battery included a self-administered socio-gambling demographic questionnaire, the Diagnostic and Statistical Manual Fourth Edition Multiple Response Juvenile (DSM-IV-MR-J) diagnostic instrument to assess problem gambling status, the Gambling Attitudes Scale, and questionnaires using a Likert scale to measure gambling-related harms and help-seeking behaviours. The prevalence rate among this group was found to be 6.7%. The study found further support for previous findings suggesting that a significant proportion of young people meet criteria for problem gambling, that males are at-risk and that few adolescents are able to recognise when gambling is problematic or access mental health professionals for assistance.     

Impulse Control Disorder Behaviors Associated with Pramipexole Used to Treat Fibromyalgia

Objective: Compulsivity has been associated with use of dopamine agonists used to treat Parkinson’s disease (PD). Increasing use of these agents to treat fibromyalgia (FM) raises concern for this unexpected toxicity in a new group of patients. This is the first report of compulsive gambling and shopping among patients taking dopamine agonists for treatment of FM. Design: A retrospective chart review of all patients in a large, active FM research practice was used to identify compulsivity associated with dopamine agonists and describe its remission following dug withdrawal. Results: Of 3006 patients with FM treated between 2002 and 2006, 1356 had taken ≥1 dose of a dopamine agonist ( >95% pramipexole). Twenty-one (3 male, 18 female) were identified with compulsive gambling (33%), shopping (40%) or both (27%) after taking a 4.5 mg mean dose of pramipexole at bedtime for 14.4 ± 14.9 months. Compulsivity resolved in 3–10 days for 19 of 21 patients and by 3 months for all following a monitored, compulsory tapered discontinuation over 7 days. Conclusions: While biologic aspects of PD and FM differ considerably, compulsive gambling and shopping have become important, yet unexpected concerns related to use of dopamine agonists for patients with FM and their treating clinicians.     

Is Executive Cognitive Function Associated with Youth Gambling?

Our objectives for this report were to identify trajectories of youth gambling behavior, and to examine their relation to executive cognitive function (ECF) and associated problem behaviors. Philadelphia school children, enrolled at ages 10–12 years (n = 387; 49% male), completed three annual assessments of risk behaviors, ECF, impulsivity, problem behaviors and demographics. Across ages 10–15 years, using methods from Nagin et al., two groups were identified: Early Gamblers (n = 111) initiated early and continued in later assessments, and Later Gamblers (n = 276) initiated at later ages and gambled less. Betting money on cards and sports were the most frequently reported gambling behaviors. Using gambling group as outcome, final backward selection logistic regression model showed Early Gamblers are more likely male (P = 0.001), report more active coping (P = 0.042), impulsive behaviors (P ≤ 0.008), and have friends who gamble (P = 0.001). Groups were similar in ECF, parental monitoring, marital status, SES, and race. Early Gamblers had higher incidence of problem behaviors and drug use (all P ≤ 0.006). Two gambling groups were identified in early adolescence with Early Gamblers showing higher levels of impulsivity and comorbid problems but similar levels of ECF compared to Late Gamblers. As more gambling groups are identified through later adolescence, ECF may emerge as a relevant precursor of problem gambling at this later time.     

Beliefs About and Attitudes Toward Gambling in French-Speaking Switzerland

The present study aims to analyze attitudes and beliefs of the French-speaking general Swiss population (n = 2500; female n = 1280; mean age = 43 years) as regards gambling, which are to date almost exclusively studied in the North American and Australian contexts. Beliefs related to gambling include the perception of the effectiveness of preventive measures toward gambling, the comparative risk assessment of different addictive behaviors, the perceived risks of different types of gambling and attitudes are related to the gambler’s personality. The general population perceived gambling rather negatively and was conscious of the potential risks of gambling; indeed, 59.0% of the sample identified gambling as an addictive practice. Slot machines were estimated to bear the highest risk. Compared with women and older people, men and young people indicated more positive beliefs about gambling; they perceived gambling as less addictive, supported structural preventive measures less often, and perceived gambling as a less serious problem for society. Gamblers were more likely to put their practices into perspective, perceiving gambling more positively than non-gamblers. General population surveys on such beliefs can deliver insights into preventive actions that should be targeted to young men who showed more favorable views of gambling, which have been shown to be associated with increased risk for problematic gambling.     

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.     

Electronic Gaming Machine Gambling: Measuring Motivation

Electronic gambling machines (EGMs) are known to be a particularly risky form of gambling (Petry. Addiction 98(5):645–655, 2003). It is vital that researchers and clinicians are aware of factors which could lead to people having problems with this form. Gambling motivation is one such factor. This study developed a measure of EGM gambling motivations based on the results of qualitative research conducted with EGM problem gamblers and experienced counsellors (Thomas et al. Int J Mental Health Addiction 7:97–107, 2009). A community based sample of 232 females (M = 29.60 years of age, SD = 15.41 years) and 123 males (M = 29.64 years of age, SD = 12.29 years) participated. Exploratory factor analysis extracted three motivational factors indicating people gambled on EGMs to escape, for its accessibility and for the social environment. Gambling to escape and for its accessibility had substantial positive correlations with frequency of EGM gambling and gambling problems. Social environment correlated less well with these indicators of excessive gambling. Correlations between factors suggested the accessible, social experience offered by EGM venues increases their appeal as a means of escape. The new subscales were internally consistent and demonstrated good evidence of validity. This new measure will facilitate future investigations into the relationships between gambling motivations, other aetiological factors and EGM problem gambling.     

Factors Associated with Gamblers: A Population-based Cross-sectional Study of South Australian Adults

Objective To determine, using a random telephone survey, the prevalence of various gambling activities among South Australian adults, the prevalence of adult problem gamblers using the South Oaks Gambling Screen (SOGS) instrument, and to examine the problem gamblers by demographic and health-related risk factors.Method A random representative sample of South Australian adults selected from the Electronic White Pages. Overall, 6045 interviews were conducted (73.1% response rate) using Computer Assisted Telephone Interviewing (CATI) technology.Results Overall, 75.6% (95% CI: 74.5–76.7) of respondents had participated in at least one gambling activity during the last 12 months and 2.0% (95% CI: 1.7–2.4) were identified to be problem gamblers. A wide range of factors was associated with problem gambling at a univariate level, when compared to frequent gamblers. The logistic regression analysis highlighted that problem gamblers were more likely to speak a language other than English, be employed part time and a smoker when compared to frequent gamblers. Problem gamblers were also more likely to have a mental health condition (according to the Kessler 10), have had suicidal thoughts and know of services for gambling problems.Conclusion There is a wide range of characteristics associated with problem gambling in South Australia. All of these factors need addressing during policy development to assist problem gamblers.     

Predictors of adverse gambling related consequences among adolescent boys

Although gambling is illegal for minors, adolescents do gamble and even higher proportions of adolescents than adults are at risk to become problem gamblers. Moreover, many adolescents suffer from a wide range of gambling related harms, and this study sought to examine what predicts different adverse consequences of adolescent gambling. Our aim was to test whether various cognitive, motivational and behavioural factors were associated with psychosocial consequences and loss of control, and with interpersonal and financial consequences of gambling, as measured by the Canadian Adolescent Gambling Inventory, the only instrument developed specifically for use on adolescents. The data was collected on a convenience sample of 1330 male Croatian students (Mage = 16.58, SDage = 1.16) from all three types of secondary education in Croatia. Results show that a high proportion of adolescents gamble, and that almost half of them are either at risk or can already be considered problem gamblers. Sport betting, VLT machines and betting on virtual horse races were the most frequent gambling activities for Croatian high-school boys. Hierarchical regression models showed that psychosocial consequences and loss of control can be predicted by higher frequency of gambling, previous experience with winning money and a specific motivation to earn money gambling, to become a better gambler and with having a drive to continue gambling after winning. On the other hand, interpersonal and financial consequences were predicted again by a higher frequency of gambling, the motive to be a better gambler and the drive to continue gambling after winning, but also by specific motivation to relax and feel better. Having more cognitive distortions, specifically having poorer understanding of chance and probabilities and more superstitious beliefs, as well as engagement in general risky and antisocial behaviour also predicted more interpersonal and financial consequences. Findings are discussed in the context of practical implications for prevention programs of adolescent gambling.     

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.     

How Do Gamblers End Gambling: Longitudinal Analysis of Internet Gambling Behaviors Prior to Account Closure Due to Gambling Related Problems

Objective: To examine behavioral patterns of actual Internet gamblers who experienced gambling-related problems and voluntarily closed their accounts. Design: A nested case–control design was used to compare gamblers who closed their accounts because of gambling problems to those who maintained open accounts. Setting: Actual play patterns of in vivo Internet gamblers who subscribed to an Internet gambling site. Participants: 226 gamblers who closed accounts due to gambling problems were selected from a cohort of 47,603 Internet gamblers who subscribed to an Internet gambling site during February 2005; 226 matched-case controls were selected from the group of gamblers who did not close their accounts. Daily aggregates of behavioral data were collected during an 18-month study period. Main outcome measures: Main outcomes of interest were daily aggregates of stake, odds, and net loss, which were standardized by the daily aggregate number of bets. We also examined the number of bets to measure trajectory of gambling frequency. Results: Account closers due to gambling problems experienced increasing monetary loss as the time to closure approached; they also increased their stake per bet. Yet they did not chase longer odds; their choices of wagers were more probabilistically conservative (i.e., short odds) compared with the controls. The changes of monetary involvement and risk preference occurred concurrently during the last few days prior to voluntary closing. Conclusions: Our finding of an involvement-seeking yet risk-averse tendency among self-identified problem gamblers challenges the notion that problem gamblers seek “long odds” during “chasing.”     

Is Speeding a Form of Gambling in Adolescents?

Speeding is a major contributor to motor vehicle accidents, which are the leading cause of death in adolescents. This study compares the extent to which adolescents with gambling behavior and substance use reported driving over the posted speed limits (“speeding”). Florida adolescents ages 13–17 (n = 1051) were surveyed, and asked about gambling activities, problems related to gambling, substance use, demographic questions, and speeding. Of the 562 respondents who were drivers, the gender distribution was 52.1% male and 47.9% female. Of those respondents, 76.9% were Caucasian, 6.8% were African American, 10.1% were Hispanic, and 6.1% were Native American/Asian/Other. Simple correlation analysis revealed that self-reported speeding is significantly related to gambling behavior and substance use. When a linear regression model was used, four factors showed the most significant influence on self-reported speeding: past year gambling tendency, age, trouble with the police due to drinking, and tranquilizer usage. Gambling behavior and high-risk speeding (driving ≥ 10 mph over speed limit) also were noted to be positively correlated. Our data indicate a relationship between risky driving, gambling, and other risk-taking behaviors in adolescents, and support the hypothesis that speeding may be a form of gambling behavior in this age group.     

Problem Gambling Among Urban and Rural Gamblers in Limpopo Province,South Africa: Associations with Hazardous and Harmful Alcohol Use and Psychological Distress

Little is known about the mental health correlates of problem gambling in low- and-middle-income countries such as South Africa and whether these correlates vary by urbanicity. To address this gap, we examined mental health factors associated with problem gambling among gamblers in Limpopo Province, South Africa disaggregated by rural, peri-urban and urban location. A survey of gambling behaviour and mental health was conducted among 900 gamblers. Overall, 28.3 % were at high risk and 38.1 % were at moderate risk for problem gambling. For the entire sample, hazardous/harmful alcohol use was associated with almost twofold increased chance of being at moderate risk (AOR 1.83; 95 % CI 1.08, 3.11) and almost sevenfold greater odds (AOR 6.93; 95 % CI 4.03–11.93) of being at high risk for problem gambling. Psychological distress was associated with being at high risk for problem gambling only (AOR 1.18; 95 % CI 1.14–1.22). After stratifying by urbanicity, hazardous/harmful alcohol use and psychological distress remained associated with high risk gambling across all locations. We found little knowledge of a free gambling helpline and other gambling services—particularly in less urbanised environments [χ² (2), 900 = 40.4; p < 0.001]. These findings highlight the need to increase awareness of free helpline services among gamblers and to ensure gambling services include screening and treatment for common mental disorders.     

Gambling and Problem Gambling Across the Lifespan

Two national U.S. telephone surveys of gambling were conducted, an adult survey (age 18 and over, N = 2,631) in 1999–2000 and a youth (age 14–21, N = 2,274) survey in 2005–2007. The data from these surveys were combined to examine the prevalence of any gambling, frequent gambling and problem gambling across the lifespan. These types of gambling involvement increased in frequency during the teens, reached a high level in the respondents’ 20s and 30s, and then fell off in as the respondents aged. The notion that gambling involvement generally, and especially problem gambling, is most prevalent during the teens was not supported. A comparison of the age patterns of gambling involvement and alcohol involvement showed that alcohol involvement peaks at a younger age than gambling involvement; and thus, the theory that deviant behaviors peak at an early age applies more to alcohol than to gambling.     

Gambling Behavior Among Adolescents with Attention Deficit/Hyperactivity Disorder

Impulsivity is inherent to both problem gambling and ADHD. The purpose of this study is to examine ADHD key symptoms, and gambling behaviors and problem severity among adolescents. Additionally, internalizing and externalizing behaviors exhibited among these individuals and the role of these symptoms in gambling are examined. We used a cross-sectional study design and survey 1,130 adolescents aged 12–19. Results indicated that adolescents who screened positive for ADHD were significantly more likely than non-ADHD adolescents to engage in gambling and significantly more likely to develop gambling problems. Those who screened positive as predominantly inattentive and those who screened positive for ADHD Combined (Inattention and Hyperactivity–Impulsivity) were equally likely to gamble, but the latter were twice as likely to have gambling problems. However, we found no significant interaction between the key ADHD symptoms and gambling as the severity of hyperactivity–impulsivity or inattention did not significantly differ with respect to gambling pathology. Emotional problems and depressive affect were the only variables that could significantly differentiate the ADHD types and gambling severity. Our Results highlight the clinical importance of considering the subtype of ADHD among gamblers and the greater association of depressive affect and emotional problems with gambling among adolescents.