Psychophysiological and Subjective Arousal during Gambling in Pathological and Non-pathological Video Lottery Gamblers

Two groups of video lottery gamblers (pathological N =30, and non-pathological N =34) were compared while they participated in gambling and gambling related tasks using subjective ratings of excitement, electromyographic activity (EMG), skin conductance level (SCL) and heart rate (HR). Although the groups experienced similar levels of increased physiological response the pathological gamblers reported greater levels of subjective excitement. It was concluded that the pathological and non-pathological gamblers might perceive their responses to gambling and gambling related situations differently.     

Cue Reactivity in Active Pathological,Abstinent Pathological,and Regular Gamblers

Twenty-one treatment-seeking pathological gamblers, 21 pathological gamblers in recovery, and 21 recreational gamblers watched two video-taped exciting gambling scenarios and an exciting roller-coaster control scenario while their arousal (heart rate and subjective excitement) and urge to gamble were being measured. The gamblers did not differ significantly in cue-elicited heart rate elevations or excitement. However, the active pathological gamblers reported significantly greater urges to gamble across all cues compared to the abstinent pathological gamblers and, with marginal significance (p = 0.06), also compared to the social gamblers. Further exploration of these findings revealed that active pathological gamblers experience urges to gamble in response to exciting situations, whether or not they are gambling related, whereas abstinent and social gamblers only report urges to an exciting gambling-related cue. This suggests that for pathological gamblers excitement itself, irrespective of its source, may become a conditioned stimulus capable of triggering gambling behavior. Implications for treatment and future research are discussed.     

Treatment Goal Selection for Female Pathological Gambling: A Comparison of Abstinence and Controlled Gambling

The current study was an exploratory investigation of the selection of controlled gambling as a goal of treatment for female pathological gambling. Specifically, it aimed to explore: 1) the popularity of controlled gambling as a goal of treatment; 2) the reasons pathological gamblers select abstinence and controlled gambling as goals of treatment; and 3) the characteristics of pathological gamblers attracted to abstinence and controlled gambling. The sample comprised 85 female pathological gamblers attending a cognitive-behavioural treatment program for pathological gambling. The selection of controlled gambling by one-third (34%) of the sample suggests that, at least in the Australian context, controlled gambling is a relatively popular goal of treatment for female pathological gamblers. In this study, the only differences between treatment-seeking female pathological gamblers selecting abstinence and controlled gambling were that those selecting controlled gambling were older and were less likely to endorse the belief that problematic gambling is a disease or affliction that can only be overcome by lifelong abstinence. Further research investigating the characteristics of pathological gamblers associated with controlled gambling as both a goal and outcome of treatment is required in order to ensure that treatment-seeking pathological gamblers can make an informed decision regarding their goal selection.     

Event frequency,excitement and desire to gamble,among pathological gamblers

In this study we compared gambling behaviour of 15 pathological gamblers (PG) and 15 non-problem gamblers (NPG) on two conditions of a commercially available slot machine. One condition used a commercially available two-second event frequency (games per minute), while the other condition used an experimental three-second event frequency. The payback percentage (wins relative to losses) and reward frequency (wins over number of games played) varied randomly across conditions. The results showed that PG had significantly higher measures than NPG on time spent gambling, excitement level and desire to play again in the two-second condition. In the three-second condition there were no differences in excitement level and desire to play again. The number of PG playing the maximum time (60 minutes) was reduced in the three-second version, and reward frequency contributed to reduction in time spent gambling. The results may have implications for understanding behavioural mechanisms of pathological gambling among slot machine players.     

Problem Gambling and Comorbid Psychiatric and Substance Use Disorders Among Drug Users Recruited from Drug Treatment and Community Settings

Little is known about gambling rates of drug users recruited from drug treatment compared with those recruited from the community. We use the Diagnostic Interview Schedule (DIS) to provide lifetime prevalence estimates of problem gambling (i.e., at least one gambling problem) and DSM-III-R pathological gambling (i.e., at least four gambling problems) and describe the association between gambling and psychiatric disorders for drug users recruited from drug treatment settings (n = 512) and from the community (n = 478). We also report the relative risk of being a recreational and problem gambler in this sample. The sample was first interviewed in 1989–90 as a partof two NIDA-funded St. Louis-based studies. The prevalence of problem gambling in the overall sample was 22% and the prevalence of pathological gambling was 11%. There were no statistically significant differences in problem and pathological gambling rates for subjects recruited from drug treatment and those recruited from the community. The conditional prevalence rates, that is, the rate of problem and pathological gambling only among gamblers were 27% and 13.5%, respectively. Major findings indicate that problem gambling was associated with Antisocial Personality Disorder (ASPD), even after controlling for recruitment source and socio-demographic characteristics. In fact, when examining the temporal order of these disorders, we found that pathological gambling was always secondary to ASPD, occurring on average 11.4 years after the onset of ASPD. Problem gamblers, compared with everyone else, were more likely to be male, African-American, recruited from drug treatment, have ASPD and be dependent on illicit drugs. Multinomial logistic regression analysis predicted the relative risk of being a recreational and problem gambler (compared with a nongambler) in this sample according to socio-demographics, ASPD, and dependence on illicit drugs. Results imply that screening for gambling problems will need to be broad-based among drug users.     

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.     

Cortisol Rise Following Awakening Among Problem Gamblers: Dissociation from Comorbid Symptoms of Depression and Impulsivity

Gambling pathology has been associated with elevated levels of distress, depression and impulsivity. The present investigation assessed whether these behavioral features would be evident among problem gamblers as they are among pathological gamblers. As well, given that gambling has been associated with increased life stress, as an objective index of ongoing distress, elevations of morning cortisol levels were assessed in problem and pathological gamblers relative to recreational gamblers, and their relations to depressive symptoms and impulsivity were assessed. Recreational, problem, and pathological gamblers (N = 140) completed the Beck Depression Inventory and the Barratt Impulsiveness Scale-11, and provided saliva samples at awakening, 30 min, 3.5 h, and 5.5 h afterward. Consistent with the view that problem and pathological gambling are associated with elevated life stressors, the rise of morning cortisol from awakening to 30 min following awakening was greater than in recreational gamblers. Heightened impulsivity was evident among both problem and pathological gamblers, whereas depressive symptoms were only evident among pathological gamblers. In neither instance were these psychological indices related to the morning cortisol rise. Indeed, increased depressive symptoms were not evident among problem gamblers, despite the fact that elevated morning cortisol levels were evident. The elevated morning cortisol rise may be secondary to gambling problems or distress related to gambling problems. Furthermore, the sustained morning cortisol elevations may be indicative of allostatic overload, and could potentially be a harbinger for potential health risks among problematic gamblers.     

‘It wasn't a very encouraging environment’: influence of early family experiences on problem and at-risk gamblers in Victoria,Australia

Prior research suggests that at-risk and problem gamblers are more likely to have experienced early family dysfunction and exposure to gambling within the family in early childhood. However, little is known about the ways in which early childhood experiences contribute to at-risk and problem gambling in adulthood. Drawing on life history interviews with 48 participants, this article shows that the vast majority of regular gamblers in our study had been exposed to gambling as children in their family of origin. It also shows that different experiences of gambling within the early family were associated with contrasting gambling forms and risk levels in adulthood. Several at-risk and problem gamblers reported having had a parent or other family member with problematic gambling behaviour, while low-risk gamblers had experienced gambling in their early family life as purely recreational. In addition, the majority of the problem and at-risk gamblers had experienced conflicts, lack of encouragement and support, negativity, emotional distance and lack of communication in their early family life. A few also reported experiencing various forms of abuse as children. This paper shows that early exposure to problematic gambling and early family dysfunction impacted substantially on the participants' lives as adults and contributed to problem gambling.     

Temperament and Character in Pathological Gambling

Objective We have studied temperament and character in pathological gambling (PG). Methods Thirty-eight DSM-IV verified pathological gamblers (31 males and 7 females; mean age 35.4 ± 10.4 years) were tested with Cloninger’s Temperament and Character Inventory (TCI). Matched controls were chosen from the normal population. Results Pathological gamblers scored higher on the temperament factors novelty seeking (NS) and harm avoidance (HA). The most pronounced difference was found in the character factor self-directedness (SD). The pathological gamblers differed from controls in cooperativeness and self-transcendence. A personality disorder was found in 29% of the pathological gamblers 84% of whom scored either low on SD and high on impulsivity or had a more dishonest behaviour. Two-thirds of pathological gamblers showed immature character with or without high HA in temperament. The other third showed normal-character extravagant behaviour (86%), high impulsivity (36%) and less responsibility (50%) being the most common personality traits. Conclusion HA and NS might be trait-like characteristics in PG.     

Gambling and Problem Gambling Among Recently Sentenced Women in New Zealand Prisons

Ninety-four recently sentenced women prisoners were interviewed to assess aspects of their gambling involvement, problem gambling and relationships between gambling and criminal offending. A third of the women, on the basis of their SOGS-R scores, were assessed as lifetime probable pathological gamblers and just under a quarter were assessed as probable pathological gamblers during the 6 months prior to imprisonment. For women prisoners, a preference for non-casino gaming machines and housie were predictive of problem gambling. Relative to non-problem gamblers, problem gamblers experienced higher rates of childhood conduct disorder and current non-psychotic mental disorder. Just over a quarter of prisoners and a half of the problem gamblers had committed a crime to obtain money to gamble. Few women said their early offending or convictions related to gambling. It was concluded that most women were “criminals first and problem gamblers second” rather than people whose offending careers commenced as a consequence of problem gambling. However, the extent of problem gambling-related offending among the women prisoners highlights the potential for comprehensive assessment and treatment programs in prison to reduce recidivism and other adverse impacts of problem gambling and gambling-related offending.     

Description and pre-post evaluation of a telephone and Internet based treatment programme for pathological gambling in Norway: a pilot study

Although the effectiveness of treatments for pathological gamblers is gaining support, only 10% of pathological gamblers seek treatment. Providing treatment via the Internet may lower the thresholds for treatment seeking. A new telephone and Internet based treatment programme for pathological gamblers is presented in this article, along with a pre-post evaluation of the programme. The participants (N = 112) were problem gamblers who were either self-referred or referred by their general practitioner. Data from post-treatment and 3-month follow-up are evaluated. The results suggest that using Internet and telephone-assisted treatment interventions can significantly reduce symptoms of pathological gambling (measured by the South Oaks Gambling Screen – Revised). The intervention was also associated with improvement on cognitive distortions, measured by the Gamblers Belief Questionnaire, and general psychological distress and psychopathology as measured by the Symptom Checklist-90-Revised. Although Internet-based treatment programmes have been suggested to have advantages compared to traditional face-to-face therapy, research in this area is scarce. This pilot study contributes to the growing literature in this area, and provides tentative support for the effectiveness of Internet based treatment interventions for pathological gamblers.     

The Experience of Gambling and its Role in Problem Gambling

This paper reports on the results of a psychological study conducted in Ontario, Canada, that attempted to answer the question of why some people develop gambling problems while others do not. A group of social gamblers (n = 38), sub-clinical problem gamblers (n = 33) and pathological gamblers (n = 34) completed a battery of questionnaires. Compared to non-problem gamblers, pathological gamblers were more likely to report experiencing big wins early in their gambling career, stressful life events, impulsivity, depression, using escape to cope with stress and a poorer understanding of random events. We grouped these variables into three risk factors: cognitive/experiential, emotional and impulsive and tested the extent to which each risk factor could differentiate non-problem and pathological gamblers. Each risk factor correctly identified about three-quarters of the pathological gamblers. More than half (53%) of the pathological gamblers had elevated scores on all three risk factors. Interestingly, 60% of the sub-clinical cases had elevated scores on only one risk factor. The results are interpreted in terms of a bio-psycho-social model of gambling addiction.     

The Role of Perceived Control and Overconfidence in Pathological Gambling

Two studies sought to determine whether perceived control has different effects on confidence assessment and betting decisions among pathological and problem gamblers than among non-problem gamblers. In Study 1, 200 college students who were frequent gamblers (80 female and 120 male, median age 20) completed the South Oaks Gambling Screen (SOGS) and then engaged in a task in which they answered questions, assessed confidence in each answer, and considered bets on their answers that were fair if they were well-calibrated, but unfavorable if they were overconfident. Probable pathological and problem gamblers earned significantly fewer points than non-problem gamblers. This was due to greater overconfidence among pathological and problem gamblers, which led to systematically less favorable bets. In Study 2, using 384 participants (105 female and 279 male, median age 20), control was independently manipulated and bets were constructed to make point value independent of overconfidence. Problem and pathological gamblers showed both greater overconfidence and greater bet acceptance. They were less affected by control in their betting decisions than non-problem gamblers, but more affected in the slope of their betting function. It is concluded that pathological and problem gamblers process information about confidence and control differently from non-problem gamblers.     

Reliability and Validity of the Pathological Gambling Adaptation of the Yale-Brown Obsessive-Compulsive Scale (PG-YBOCS)

The Yale Brown Obsessive Compulsive Scale adapted for Pathological Gambling (PG-YBOCS) was developed to measure the severity and change in severity of pathological gambling symptoms. The PG-YBOCS is a 10-item clinician-administered questionnaire that measures the severity of PG over a recent time interval (usually within the past one/two week(s)). In order to assess and validate the scale, it was administered to 337 subjects: 188 pathological gamblers and 149 healthy controls. Internal consistency and correlations between individual items and total score were assessed for various permutations of the sample. Other scales were administered to assess convergent, discriminant and content validity. Sensitivity to change was evaluated in treatment studies with fluovoxamine, lithium, and valproate. Each item was frequently endorsed across a range of severity. Good inter-rater reliability and internal consistency were obtained. The PG-YBOCS showed high validity and reliability for total score, item-total correlations, and for each subscale (Thoughts/Urges and Behavior). PG-YBOCS scores correlated with global severity and South Oaks Gambling Screen (SOGS) scores. The scale was also sensitive to change in pathological gambling severity. PG-YBOCS thus appears to be a reliable and valid measure of pathological gambling severity, and can be regarded as an important tool for clinicians and researchers treating pathological gamblers.     

Meanings of Aboriginal gambling across New South Wales,Australia

A social perspective of gambling explains gambling as a consequence of the social, structural and cultural environment in which gamblers live. In the Australian Indigenous context the social perspective is important, given the significance of community and family ties. This paper aims to explore meanings of Aboriginal gambling across New South Wales (NSW), Australia. Taking an interpretivist stance, semi-structured interviews were conducted with 13 knowledgeable Indigenous Australians, key elected and nominated state representatives. Meanings of Aboriginal gambling included the collective activity of gambling within social networks in the hope of a win. More problematic meanings of gambling were always gambling to win, chasing losses and continual financial distress which appeared to reduce social network bonds. Contrasting problem gambling with recreational gambling revealed that some Indigenous gamblers use their existing cultural and kin relationships on which many of their social networks are based to gamble together in a controlled recreational manner.     

The SOGS-RA vs. the MAGS-7: Prevalence Estimates and Classification Congruence

The purpose of this study was to compare the prevalence rate estimates and congruence in classification status derived from two popular measures of adolescent gambling (SOGS-RA and MAGS-7). Adolescents from three states (Alabama, Mississippi, and Oregon) completed an anonymous questionnaire ( n =1846 high school students total). Results indicate that the prevalence of probable adolescent pathological gambling varied both as a function of instrument and cut-off point utilized for classification (range 1.7%-8.2%). Classification groups (non-problem, at-risk, and problem gamblers) generated by both instruments were found to be associated with reports of gambling frequency, amount of money lost in one gambling occasion, and parental gambling problems. However, concern was raised because the MAGS-7 and the SOGS-RA had little congruence in their three-group classification decisions for specific individuals (e.g., only 20.5% agreement for problem gamblers). To improve clinical utility, an empirical case was made for using the SOGS-RA to generate a fourth group of adolescent gamblers, which we labeled "probable pathological gamblers" (SOGS-RA > or = 6). This group was differentiated from the remaining gambling groups on all the validity indices. The implications and limitations of these findings, as well as future directions, are discussed.     

Pathological Gambling: Influence of Quality of Life and Psychological Distress on Abstinence After Cognitive-Behavioral Inpatient Treatment

The aim of this study is to understand the influence of psychological distress and quality of life on the maintenance of therapy success during a 1 year follow-up in pathological gamblers after inpatient cognitive-behavioral treatment. In a sample of 281 pathological gamblers (247 men, 34 women) the following measures were taken: psychological distress (beginning and end of treatment, and follow up), quality of life and abstinence from gambling. The results showed that relapsed pathological gamblers suffer of higher psychological distress at discharge and of lower quality of life during follow-up than abstinent gamblers. In a mediator analysis the causal relations between the three variables could be clarified: psychological distress has an impact on abstinence during follow-up, and quality of life can be considered a mediator variable for the relation between psychological distress and abstinence from pathological gambling.     

Gambling Motivation and Passion: A Comparison Study of Recreational and Pathological Gamblers

The aim of this study was to examine the structural relationship among gambling motivation, gambling passion, and behavioral intentions to gamble between recreational and pathological gamblers. Specifically, this study aimed to shed light on the different ways in which gambling motivation and affective attitude are associated with recreational and pathological gamblers. Using a purposive sampling method, 400 subjects were selected for and participated in this study during their visits to a casino. Study results echoed the notion of distinctive and separate gambling motivations and passions between recreational and pathological gamblers. Also, results identified specific areas to which casino operators or policy makers should pay special attention in developing effective marketing strategies to promote responsible gambling.     

Comorbid mood and adjustment disorders among pathological gamblers seeking treatment in Hong Kong

Research findings on comorbidity and pathological gambling are non–existent in Chinese communities. The objectives of this study were to: (a) determine the prevalence of comorbid mood and adjustment disorders among pathological gamblers seeking treatment in Hong Kong; (b) compare demographic profiles and clinical features in pathological gamblers with and without comorbid mood and adjustment disorders; and (c) explore the association and temporal relationship between pathological gambling and comorbid mood and adjustment disorders. Assessment instruments included demographic data, BSI, SCID-I, ASI and LIFE-RIFT. Results showed that about two-thirds (63.7%; n = 128) of 201 participants reported lifetime comorbid psychiatric disorders. Most common comorbid disorders were mood disorders (29.4%; n = 59) and adjustment disorders (20.9%; n = 42). Pathological gamblers with comorbid mood or adjustment disorders showed more severe levels of psychopathology, impairment in psychosocial functioning and gambling problems. This study is important because it is the first scientific comorbidity study among pathological gamblers in a Chinese context.     

Alcohol’s Effects on Video Lottery Terminal (VLT) Play Among Probable Pathological and Non-Pathological Gamblers

This study tested whether alcohol increases behaviors associated with video lottery terminal (VLT) play, particularly among probable pathological gamblers. Forty-four regular VLT players were designated either probable pathological gamblers or non-pathological gamblers on the basis of scores on the South Oaks Gambling Screen (SOGS); [Lesieur & Blume (1997). American Journal of Psychiatry, 144, 1184–1188] Gamblers from each SOGS category were randomly assigned to either a moderately intoxicating alcohol dose or a control beverage condition (n = 11 per cell in the 2 × 2 between-subjects design). Following beverage consumption and absorption, participants played a video poker VLT game for up to 30 minutes. Four behaviors were measured: “power-bets” (doubling bet after viewing only two cards of the five-card poker hand); total money spent; mean bet magnitude; and number of minutes played. Alcohol increased time spent playing and rate of power-bets, particular among the probable pathological gamblers. Post hoc analyses revealed that alcohol also influenced the proportion of losing hands played––increasing them among the probable pathological gamblers while decreasing them among the non-pathological gamblers. Clinical and policy implications of the findings are discussed.