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.     

Marital Status and Problem Gambling Among Australian Older Adults: The Mediating Role of Loneliness

Problem gambling rates in older adults have risen dramatically in recent years and require further investigation. Limited available research has suggested that social needs may motivate gambling and hence problem gambling in older adults. Un-partnered older adults may be at greater risk of problem gambling than those with a partner. The current study explored whether loneliness mediated the marital status–problem gambling relationship, and whether gender moderated the mediation model. It was hypothesised that the relationship between being un-partnered and higher levels of loneliness would be stronger for older men than older women. A community sample of Australian men (n = 92) and women (n = 91) gamblers aged from 60 to 90 years (M = 69.75, SD = 7.28) completed the UCLA Loneliness Scale and the Problem Gambling Severity Index. The results supported the moderated mediation model, with loneliness mediating the relationship between marital status and problem gambling for older men but not for older women. It appears that felt loneliness is an important predictor of problem gambling in older adults, and that meeting the social and emotional needs of un-partnered men is important.     

The Association Between Loneliness, Social Isolation and Women's Electronic Gaming Machine Gambling

Since the introduction of electronic gaming machines (EGMs) in Victoria, Australia, the visibility of women as gamblers has greatly increased, yet few researchers have explored female gambling patterns and motives. An exception was a study by Brown and Coventry (1997), involving a phone-in of women with gambling problems, and analysis of gambling support service data. Results led the authors to suggest that the most common motivations for women gambling were boredom, loneliness and isolation. The current research assessed this claim through a comparative study of female EGM gamblers and non-gamblers, matched for age and education and drawn from the same geographic location. Data indicated that gambling women in general (N = 38) did not report higher levels of loneliness or social isolation than non-gambling women (N = 57). However, the sub-group of women classified though the South Oaks Gambling Screen as having gambling problems (N = 18) were significantly more lonely (in the sense of alienated rather than friendless or isolated) than the rest of the sample, including both non-gamblers and those who gambled but experienced only minor, or no problems with this activity. Problem gambling women were also more likely to be involved in social networks for which gambling was normative. The study is suggestive of loneliness (or alienation) as either a consequence or a vulnerability factor for problem gambling, but a longitudinal research design would be needed to clarify this issue.     

Prevalence and Correlates of Problem Gambling in a Representative Sample of Norwegian 17-Year-Olds

We report data collected in a representative sample of 17-year-old Norwegians to investigate prevalence rates of non-problem, risk, and problem gambling, as measured by the Problem Gambling Severity Index (PGSI). In addition, we explored the importance of demographic, personality, motivational, social, and health variables explaining variance in adolescent gambling. Prevalence rates of risk and problem gambling were low but similar to those found in previous studies outside of Norway using the PGSI in adolescent samples. With regard to the relative importance of the various covariates, we found that motivational variables (future gambling intentions, attitudes toward gambling, and gambling-related knowledge) distinguished best between those who did not gamble, non-problem gamblers, and risk and problem gamblers. Furthermore, social variables were important covariates of adolescent gambling; significant associations were found for family and friends’ approval of gambling, parental monitoring, father’s level of education, and having relatives or friends with a history of a gambling disorder. We discuss possible reasons for differences between the covariates with regard to their importance for explaining adolescent gambling and address implications for future research.     

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.     

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.     

Metacognitions in Problem Gambling

Problem gambling is heterogeneous in nature, ranging in severity from occasional but problematic gambling episodes, to extreme, impulsive and pervasive gambling behaviour. Problem gambling may be accompanied by a sense of impaired control and can give rise to financial, interpersonal, legal and vocational costs for the sufferer, their families and society. This study investigated the relationship among metacognitions, anxiety, depression and gambling in a sample of problem gamblers. A total of 91 individuals attending gambling treatment services completed a battery of self-report instruments that consisted of the Metacognitions Questionnaire 30 (MCQ-30), the Hospital Anxiety and Depression Scale (HADS) and the South Oaks Gambling Scale (SOGS). Correlation analyses showed that anxiety, depression and metacognitions were positively and significantly correlated with both gambling consequences and behaviour. Hierarchical regression analyses indicated that two metacognitive constructs (negative beliefs about thoughts concerning uncontrollability and danger and beliefs about the need to control thoughts) predicted gambling behaviour independently of anxiety and depression. These findings are consistent with the hypothesis that metacognitions play a role in problem gambling.     

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.     

Family violence in gambling help-seeking populations

Elevated rates of family violence among treatment-seeking problem gamblers compared to general population estimates have been reported in Spain, Canada and Australia. This study examined the occurrence of family violence among 454 problem gambling help-seeking clients (370 gamblers, 84 affected others) recruited through 3 national gambling treatment services in New Zealand. Measures used were the Problem Gambling Severity Index, and a modified version of the HITS Scale which assessed physical, emotional, verbal and sexual abuse. Past-year family violence among gamblers in this sample was 46.8% for victimization, 41.2% for perpetration and 55.0% for any form of family violence. Among affected others the occurrence was 65.5% for victimization, 57.1% for perpetration and 71.4% for any form of violence. The most common type of violence was verbal intimate partner violence. Affected others and women gamblers reported higher rates of violence victimization and perpetration. These findings underscore the importance of screening gambling help-seeking clients for family violence, and the development of prevention and treatment programmes to address violence in this population, with particular attention to affected others and women gamblers. Future research should assess coercive control and the gendered nature of family violence among problem gambling help-seekers.     

Pathways and transitions of gamblers over two years

Moderate-risk and problem gamblers represent 1.4% and 0.4% of the Québec population, respectively. Research on gamblers’ trajectories has been hampered by methodological shortcomings leading to heterogeneous results. The present research was conducted in the Province of Québec with a representative sample of adult gamblers and aims to explore how gamblers change over time according to the severity of their gambling problems. Using a 2-year follow-up prospective design (3 waves), 179 gamblers selected from a representative survey were divided into the 4 PGSI (Problem Gambling Severity Index) categories. Beyond the decreasing trend in PGSI scores detected within the overall sample using a linear growth model, our analyses revealed that moderate-risk gamblers are heterogeneous in their composition and evolution, comprising stable moderate-risk, recent cases and former problem gamblers. Over three waves, one-third of moderate-risk gamblers improved, one-third remained stable and one-third became problem gamblers. The subgroups transitioning in and out of the moderate-risk category differed in terms of reported changes in gambling behaviours and consequences. Problem gamblers remain vulnerable over time, being at risk of experiencing chronic problems. Results highlight the necessity of subgroup-specific prevention programmes and treatment services that address both the non-linearity of risky gambling and the chronicity of problem gambling.     

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.     

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.     

Health Outcomes in Individuals with Problem and Pathological Gambling: An Analysis of the 2014 North Carolina Behavioral Risk Factor Survey System (BRFSS)

Problem and pathological gambling refers to subclinical and clinical levels of maladaptive gambling, respectively, and is associated with specific sociodemographic characteristics as well as a number of poor health outcomes. We examined such demographic, physical health, mental health, and health-related behaviors in a sample of 7045 low-risk gamblers and 244 problem/pathological gamblers. Participants completed the 2014 North Carolina Behavioral Risk Factor Surveillance System telephone survey. Using the National Opinion Research Center’s Diagnostic Screen for Gambling Disorders-CLiP, participants were categorized as either “problem/pathological gamblers” or “low-risk gamblers.” Problem/pathological gamblers were younger, more likely to be male, of ethnic minority status, unmarried, and of lower education than low-risk gamblers. No physical health variables differentiated the groups but problem/pathological gamblers reported experiencing significantly more adverse childhood experiences and engaging in significantly more tobacco and alcohol use compared to low-risk gamblers. Moreover, gender moderated relationships between gambling group and several of the alcohol use variables such that male problem/pathological gamblers exhibited greater alcohol use behavior than male low-risk gamblers but no such relationship was present in females. Overall, this study expands the current knowledgebase on disordered gambling and highlights the need to assess disordered gambling in public health samples. Clinical implications are discussed.     

Impulsivity and Gambling Type Among Treatment-Seeking Disordered Gamblers: An Explorative Study

Several studies have found that certain traits of impulsivity are associated with gambling disorder, and influence its severity. Furthermore, it has been suggested that some forms of gambling, particularly electronic gambling machines, are particularly widespread among pathological gamblers. In the present, exploratory study, we aim to clarify the role played by impulsivity in influencing the choice of specific gambling activities, by examining the relation between individual dimensions of impulsivity, and the choice of specific gambling activities in a clinical population. 100 consecutively admitted pathological gamblers at the National Problem Gambling Clinic in London (UK) in 2014 were administered the UPPS-P and BIS-11 impulsivity questionnaires, the Problem Gambling Severity Index, and underwent a structured interview concerning their gambling activities in the month and year prior to assessment. The correlation between individual gambling activities and impulsivity dimensions was analyzed both at a bivariate level, and using logistic regression. We found a significant correlation between Negative Urgency, Motor impulsivity and low-stakes machine gambling on multivariate analysis. Negative urgency (i.e. the tendency to act impulsively in response to negative affect), and Motor impulsivity (a tendency to rash action and restlessness) might be mediating factors in the choice of electronic gambling machines, particularly among patients whose gambling is escape-oriented. Structural and situational characteristics of gambling machines, particularly the widespread availability of low-stakes—rather than high-stakes—gaming machines, might concur to the choice of this form of gambling among individuals who present higher negative urgency and restlessness.     

An Investigation of the Association Between Shame and Problem Gambling: The Mediating Role of Maladaptive Coping Motives

Despite often being considered equivalent affective states, shame and guilt have differential associations with problem gambling with only shame showing a strong positive association with problem gambling. However, little is known about the mechanisms underlying the shame-problem gambling association. Further, shame and guilt are associated with distinct coping strategies, with shame motivating maladaptive coping (e.g., avoidance, escape) and guilt motivating adaptive coping (e.g., taking corrective action). This study aimed to examine whether maladaptive coping motives for gambling mediate the relationship between shame, but not guilt, and gambling problems. Participants were 196 (126 male) regular gamblers who completed a same and guilt scale, the Problem Gambling Severity Index, and a modified Gambling Motives Questionnaire, which assessed individual motives to engage in gambling for coping, enhancement, or social reasons. Results indicated that coping motives for gambling fully mediated the relationship between shame and problem gambling severity, but did not mediate the association between guilt and problem gambling severity. Experiencing shame contributes to problem gambling as a result of gambling to cope with negative affect. Cultivating more adaptive strategies to cope with shame may be effective in preventing and treating problem gambling.     

Gender Differences in Characteristics of Chinese Treatment-Seeking Problem Gamblers

A total of 952 (841 men and 111 women) Chinese treatment-seeking problem gamblers completed self-report assessment forms. Female in contrast to male gamblers were more likely to be older, married, less educated, and without employment. Female gamblers also started gambling at an older age, had a shorter gambling history, preferred casino and mahjong gambling, and reported more somatic complaints and suicidal thoughts. Male and female gamblers accumulated similar amount of gambling debt and reported an average of 12 gambling-related problems on the Chinese version of the South Oaks Gambling Screen [Lesieur and Blume (Am J Psychiatry 144:1184–1188, 1987)]. Both groups were similarly troubled by their indebtedness, inability to control gambling, and gambling-related interpersonal problems. However, female gamblers had fewer means to pay their gambling debt. Given that significant gender-related differences were observed in Chinese problem gamblers, prevention and treatment services should attend to specific needs of male and female gamblers.     

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.     

A population-level metric for gambling-related harm

Prior estimates of the population-level impact of gambling have relied on economic costings. Recent work has derived disability weights for the Problem Gambling Severity Index, which measure per-person impact of gambling on quality of life on a scale of zero to one. This provided scope for the present study to calculate the ‘burden of gambling harm’, which captures the aggregate impact of harms arising from gambling on quality of life in a population. Gambling-related harm was associated with 101,675 years of life lost in Victoria, Australia: approximately two-thirds that of alcohol use and dependence, and major depressive disorder. Problem gamblers suffer more individually (disability weight = .44) compared to those in moderate (.29) and low (.13) risk categories. Nevertheless, moderate and low-risk gamblers account for 85% of population-level harm, due to greater prevalence of these groups. Overall, the scale of gambling-related harm is large relative to other significant health issues, with milder yet non-negligible harm accruing to a relatively broad segment of the gambling population. The article suggests that the tendency to conflate the (typically low) prevalence of problem gambling with total gambling impact is misleading, and argues for a broader population-health based measure.     

Alexithymia and Gambling: A Risk Factor for All Gamblers?

The purpose of this study was to investigate alexithymia (in relation with depression) in three groups of French gamblers (n = 186) recruited in their gambling location: at the racetracks (n = 80 males; mean age 28.1 years), in the slot machine rooms (n = 65; 29 males, 36 females; mean age 34.6 years), and in the traditional gaming rooms (n = 41 males; mean age 36 years). Gambling behavior was measured by the South Oaks Gambling Screen and DSM-IV criteria for pathological gambling, Alexithymia by the Toronto Alexithymia Scale (TAS-20) and depression with the Beck Depression Inventory (BDI-13). For racetracks and slot machine gambling, pathological gamblers differed from non-pathological gamblers, regarding their alexithymia scores. These results remained stable after controlling for depression scores among the racetracks gamblers only. The relationship between alexithymia and depression depends on the type of pathological gambler. These findings are consistent with the idea of identifying clinically distinct subgroups of gamblers.     

Alterations in the Emotional Regulation Process in Gambling Addiction: The Role of Anger and Alexithymia

This study aims at the assessment of alexithymia and anger levels in 100 treatment-seeking pathological gamblers compared with controls, who were matched for age, gender and education. Furthermore a positive correlation between alexithymia, anger and severity of gambling disorder and a relationship between gambling behaviour and anger after controlling for alexithymia, are investigated. Finally the role that gender plays in anger in pathological gamblers was also evaluated. Psychological assessment includes the South Oaks Gambling Screen, State-Trait Anger Expression Inventory-2 and the twenty-item Toronto Alexithymia Scale. Statistical analysis of the results shows a higher level of anger in pathological gamblers than in controls, together with alterations in emotional processing. Severity of gambling behaviour positively correlates with alexithymia scores, state-anger and trait-anger. Moreover, a significant contribution of anger in predicting gambling behaviour was suggested after controlling for alexithymia. In conclusion, anger and alexithymia must be regarded as relevant components of the assessment of pathological gamblers, in order to select the best therapeutical strategies to prevent self-defeating behaviours and to reduce drop-out from treatments.