Family,marital, and occupational satisfaction for recovering pathological gamblers

This paper describes the efforts of a private gambling treatment program to conduct a retrospective study of pathological gamblers treated in a publicly supported residential program. The Johns Hopkins Center for Pathological Gambling treated approximately 100 pathological gamblers nationwide from 1979 to 1983 in its residential component. Twenty-six gamblers were assessed regarding their recovery status with specific focus on family, marital status and occupational satisfaction. It was hypothesized that the more satisfied patients would display lower frequencies of gambling and that gambling frequency was dependent upon the level of satisfaction. Thirty-one percent of these gamblers reported abstinence. Regression analyses indicated that the recovery of pathological gamblers as measured by frequency of gambling is significantly influenced by job satisfaction, and moderately influenced by marital status and family life satisfaction. Consequently, these factors should be addressed by mental health professionals in research and treatment of pathological gambling.     

Pathological Gambling and Couple: Towards an Integrative Systemic Model

This article is a critical literature review of pathological gambling focused in the family factors, particularly in the couple dynamics. Its main goal is to develop an explicative integrative systemic model of pathological gambling, based in these couple dynamics. To achieve that aim, a bibliography search was made, using on-line data bases (e.g., EBSCO Host) and recognized books in pathological gambling subject, as well as in the systemic approach in general. This process privileged the recent works (about 70 % of the reviewed literature was published in the last decade), however, also considered some classic works (the oldest one dates back to 1970). The guiding focus of this literature search evolves according to the following steps: (1) search of general comprehension of pathological gambling (19 references), (2) search specification to the subject “pathological gambling and family” (24 references), (3) search specification to the subject “pathological gambling and couple”(11 references), (4) search of systemic information which integrates the evidence resulted in the previous steps (4 references). The developed model is constituted by different levels of systemic complexity (social context, family of origin, couple and individual) and explains the problem as a signal of perturbation in the marital subsystem vital functions (e.g., power and control) though the regularities of marital dynamics of pathological gamblers. Furthermore, it gives theoretical evidence of the systemic familiar intervention in the pathological gambling.     

Gamblers' irrational thinking about chance events: the ‘double switching’ concept

The aim of this study was to examine the association between gender and problem electronic gaming machine (EGM) gambling. One hundred and twenty-three males and 209 females (N=335; three participants did not identify their gender) with a mean age of 44.9 years were surveyed in gaming venues within Metropolitan Melbourne. The results showed a greater representation of Australian-born (74%) among the female group, compared to the male group (64%). The women were also older (47% were aged 41–60 years) than the men (48% of males were aged 19–40 years). Significant relationships were found between gender, age, marital status and religion and pathological EGM gambling. The results of this study showed the pathological EGM gambler was likely to be male, under the age of 45 years, single and possibly of the Greek Orthodox faith. Implications of this study suggest that different forms of gambling may suit different cultures and that other issues pertaining to cultural aspects of gambling need to be explored in greater depth.     

Geographical accessibility to gambling venues and pathological gambling: an econometric analysis of pachinko parlours in Japan

The relationship between geographical accessibility to gambling venues and the prevalence of pathological gambling is still unknown. This study aimed to reveal this relationship in Japan as well as its variation by subpopulation. A cross-sectional study was conducted, based on an original web-based survey to understand the level of pathological gambling depending on accessibility to pachinko parlours. Pathological gamblers were measured using the Japanese version of the South Oaks Gambling Screen. Accessibility to gambling venues was defined as the number of pachinko parlours within a 1.5 km radius from home. Moreover, the study adopted the instrumental variable approach to solve the potential endogeneity problem. The results showed that the accessibility was not significantly associated with pathological gambling in general, but that the effects of accessibility varied by subpopulation. Accessibility was significantly and positively correlated with pathological gambling for men and people in low-income areas, but this was not so for women and people in high-income areas. The study’s findings show the importance of the neighbourhood environment and could help in implementing more effective interventions for pathological gamblers.     

Factors Associated with Recreational Gambling Frequency among Older Adults

Although a steady increase in the number of legalized gambling venues is occurring, few studies have empirically investigated the determinants of recreational gambling frequency among older adults. This investigation is based on a random-digit dialling sample of 290 residents 55 and older in the Las Vegas, Nevada, USA area whom self-reported that they currently gamble, had moved to Las Vegas after the age of 18, and were not problem or pathological gamblers. Using ordinal regression methods, we examined the impact upon gambling frequency of the following factors: age when moved to the community; considerations motivating in-migration to the community; and social interaction during gambling; as well as age; sex; income; and marital status. Results indicate that more frequent gamblers are single, male, 55–60 years old, gamble with friends, moved to Las Vegas to live after the age of 40 and for whom gambling was an important motivation for moving to Las Vegas.     

Psychological characteristics of volunteers in studies on gambling

Advertisements were published in local newspapers asking for volunteers to participate in a study on gambling. A battery of eleven questionnaires was mailed to the subjects assessing pathological gambling behavior, sociodemographic characteristics, motivation to gamble, erroneous perceptions about gambling, superstitious beliefs, depressive symptoms, social anxiety and avoidance, alcohol and drug abuse, problem-solving skills, and marital satisfaction. Subjects received $10 when they returned the questionnaires fully completed. Response rate was over 95%. Surprisingly, 29% of the respondents met the criterion for probable pathological gambling (score of 5 or more on the SOGS) and a further 16% were identified as potential pathological gamblers (scores of 3 or 4). The potential and probable pathological gamblers showed significant differences on motivational and cognitive variables related to gambling compared to those subjects who showed no signs of pathological gambling. The probable pathological gamblers reported significantly more signs of poor psychosocial functioning than the other two groups, including depressive symptoms, poor problem orientation, drug and alcohol abuse, and interpersonal conflict. The practical and theoretical implications of these results are discussed.     

Age of Onset in Pathological Gambling: Clinical,Therapeutic and Personality Correlates

We aimed to explore the association between age of onset of gambling problems and current psychopathological and clinical status, personality profile and therapeutic outcome in a sample of pathological gamblers. A total of 904 consecutive pathological gambling patients were administered several instruments about gambling behavior, psychopathology and personality. They received a 4-month cognitive-behavioral group treatment. Information of dropouts and relapses during treatment was registered. Older age of onset of gambling problems was associated with higher general psychopathology (SCL-90-R Paranoid Ideation, Psychoticism, Depression; P < 0.015). Younger age of onset was related to greater severity of pathological gambling (P < 0.015), higher novelty seeking, and lower self-directedness (P < 0.015). No statistically significant association was found between age of onset and relapse and dropouts during treatment. Age of onset of gambling problems seems to influence the clinical presentation of pathological gambling but not treatment outcome.     

Pathological Gambling in Estonia: Relationships with Personality,Self-Esteem,Emotional States and Cognitive Ability

Due to changes in gambling accessibility during the last decade gambling has become more widespread in Estonia and the prevalence of pathological gambling has sharply increased. The present study attempts to identify psychological characteristics of Estonian pathological gamblers. It has been shown that a wide range of social, economic, and individual factors (e.g. personality traits and emotional states) predict the likelihood of becoming a pathological gambler. In the present study, pathological gamblers’ (N = 33) personality traits, self-esteem, self-reported emotional states and cognitive ability were compared to the respective characteristics in a non-gambling control group (N = 42) matched for age, gender and educational level. It was found that compared to controls, pathological gamblers had higher scores on Neuroticism (especially on its immoderation facet) and lower scores on Conscientiousness (especially on its dutifulness and cautiousness facets) and on self-esteem scale. They reported more negative emotional states during the previous month (especially depression and anxiety). Finally, pathological gamblers had lower general cognitive ability. In a logistic regression model, the likelihood of being a pathological gambler was best predicted by high immoderation score and low cognitive ability.

Thoughts and acts of self-harm,and suicidal ideation,in online gamblers

Gambling problems have been linked to suicidal ideation and enhanced risk of suicide attempts. However, we know very little about the factors associated with either thoughts or acts of self-harm amongst people who gamble. A web-based study of 4125 online gamblers (79% males; mean age 35.5 years), analysed using hierarchical multiple regression, revealed that self-reported non-gambling-related self-harm was negatively related to age and marital status, and positively related to problematic alcohol use. Self-reported acts of self-harm both related and unrelated to gambling were associated with drug misuse. Thoughts and acts of gambling-related self-harm were associated with problem gambling, gambling involvement and parental problem gambling. All types of self-harm were associated with mood disorder symptoms, unemployment and certain gambling motivations. When tailoring assessment and interventions for individuals at risk for gambling-related deliberate self-harm, it is important to recognize that contributory factors may include some that differ from those for deliberate self-harm in general, and that there is potential value in evaluating gambling involvement and motivations, and history of parental gambling.     

Gambling-Related Cognitive Biases and Pathological Gambling Among Youths, Young Adults, and Mature Adults in Chinese Societies

This study investigated the extent to which gambling-related cognitive biases would associate with various levels of gambling pathology among 2,835 youths, 934 young adults, and 162 mature adults in Chinese societies. Results showed that gambling cognitive biases, especially biases in perceived inability to stop gambling and positive gambling expectancy, were salient correlates of pathological gambling across the three age cohorts. Analyses of variances on total cognitive biases also showed a gambling pathology main effect and an age cohort × gambling pathology 2-way interaction effect. It was noted that the probable pathological gambling group had greater cognitive biases than the probable problem gambling group, which in turn had greater cognitive biases than the non-problem gambling group. In the non-problem gambling group, mature adults had greater cognitive biases than youths and young adults, but this pattern was reversed in the probable problem gambling group. In the probable pathological gambling group, youths had greater cognitive biases than young and mature adults. Specific categories of cognitive biases also varied according to gender and gambling pathology. While men as compared to women in the non-problem and probable problem gambling groups reported a greater bias in their perceived inability to stop gambling, no significant gender difference in this bias was found in the probable pathological gambling group. Men generally had greater perceived gambling expectancy bias than women.     

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 of Female Pathological Gambling: The Efficacy of a Cognitive-Behavioural Approach

Given that a substantial proportion of current pathological gamblers are female, it is evident that women are underrepresented in the treatment outcome literature. The current study was designed to redress the limited information on the treatment of female pathological gambling. Although the use of cognitive-behavioural therapy is the most highly recommended approach as ‘best practice’ for the treatment of pathological gambling, no attempt to date has been made to evaluate the efficacy of this approach for female pathological gambling. Nineteen female pathological gamblers with electronic gaming machine problems were treated with a cognitive-behavioural program. While pathological gamblers placed on a waiting list did not show significant improvement on gambling behaviour and psychological functioning measures, the female pathological gamblers showed significant improvement on these measures over the treatment period, and maintained this improvement at the 6-month follow-up evaluation. By the completion of the follow-up period, 89% of participants no longer met diagnostic criteria for pathological gambling. Although further scientific demonstration and replication are required, the outcomes of this study indicate that the therapy that is considered ‘best practice’ in the treatment of pathological gambling is effective for female pathological gambling.     

Gambling and Problem Gambling among Recently Sentenced Male Prisoners in Four New Zealand Prisons

Recently sentenced inmates in four New Zealand male prisons (N = 357) were interviewed to assess their gambling involvement, problem gambling and criminal offending. Frequent participation in and high expenditure on continuous forms of gambling prior to imprisonment were reported. Nineteen percent said they had been in prison for a gambling-related offence and most of this offending was property-related and non-violent. On the basis of their SOGS-R scores, 21% were lifetime probable pathological gamblers and 16% were probable pathological gamblers during the six months prior to imprisonment. Of the “current” problem gamblers, 51% reported gambling-related offending and 35% had been imprisoned for a crime of this type. Gambling-related offending increased with problem gambling severity. However, only five percent of problem gamblers said their early offending was gambling-related. The large majority reported other types of offending at this time. Few men had sought or received help for gambling problems prior to imprisonment or during their present incarceration. This highlights the potential for assessment and treatment programs in prison to reduce recidivism and adverse effects of problem gambling and gambling-related offending.     

Brief Communications: Gender Differences in Gambling Progression

The authors compared 39 women and 38 men entering an outpatient treatment program for pathological gambling. They were diagnosed according to DSM-IV and selected by SOGS, followed by a semi-structured interview for demography and progression of the gambling behavior prior to treatment. Women were more often single (59% vs. 26%; p = .005) and started gambling significantly later than men (34.2 vs. 20.4 years; p < .001). The progression of the disorder was more than 2 times faster in women than in men. There was no difference in the age of seeking treatment (44.7 vs. 42.3 years). Findings from this study resemble gender differences in other addictions—in particular the faster progression among women—challenge pharmacodynamic hypotheses for this phenomenon, and suggest gender into account when devising treatment strategies for pathological gambling.     

Dostoevsky and Freud: Autonomy and Addiction in Gambling

In this paper the modern ideal of “autonomous” or “pure” gambling is put forward in an analysis of Dostoevsky's gambling behavior, his novel The Gambler (1866) and Freud's psychoanalysis of Dostoevsky. The significance of The Gambler lies in the way conceptions of gambling are related to the social conditions of gamblers. Furthermore, the author demonstrates that Dostoevsky and Freud express contradictory views on gambling addiction. While Dostoevsky primarily appreciated roulette as a means of making money, Freud mistakenly interpreted this as a “pathological passion”. In different ways, however, both approaches toward excessive gambling presuppose and reinforce “gambling‐for‐its‐own‐sake” – Le jeu pour le jeu.     

Gambling in prison: addiction or leisure activity?

Several studies conducted around the world confirm the presence of gambling in detention facilities. Based on interviews conducted with male inmates in three Canadian penitentiaries, the authors of this article studied the reasons to gamble or not gamble in detention. The inmates' relationships with gambling prior to their incarceration were taken into consideration, to explain notably the influence of context on the reasons why they do or do not gamble. For most inmates, gambling is a good recreational alternative to boredom; however, some use it also to socialize or even protect themselves indirectly. Even more interesting is the fact that, despite the presence of gambling addicts among the inmates interviewed, none of the reasons generally associated with pathological gambling was reported during the interviews to explain gambling in detention. These results reinforce the influence of contextual factors on pathological gambling problems. Anxiety-producing factors in gamblers' lives, an environment where gambling is too accessible, as well as solitary habits, are conducive to addiction. By reducing stressful elements, as well as the availability, variety and special effects of gambling games, prison would indirectly control inmates' compulsive gambling habits during their incarceration.     

Gambling in Western and Eastern Europe: The Example of Hungary

The history of gambling in post-socialist countries is noticeably different from that of other countries in Europe. The goal of this study was therefore twofold: Firstly, to systematically review all European epidemiological studies related to excessive gambling in the general adult population, and secondly, to provide an overview of the state of gambling in Hungary based on the first ever nationwide representative survey, setting the results against the backdrop of the earlier European studies. A systematic review was carried out of European gambling studies which focus on a representative adult general population. Hungarian data was obtained from the National Survey on Addiction Problems in Hungary general adult population survey (N = 2,710). Pathological gambling was measured by the South Oaks Gambling Screen. Lifetime prevalence of excessive gambling (problem and pathological gambling) in the general adult population of European countries varies between 1.1% (Italy and Spain) and 6.5% (Estonia). In Hungary, the prevalence of problem gambling is 1.9%, with pathological gambling at 1.4%. The socio-demographic characteristics of the results are similar to those of other European countries. Using epidemiological data from the general adult populations of two post-socialist nations, it was possible to compare the results with data from 12 other European countries. Based on the data available, the extremely rapid liberation of the gambling market in the post-socialist countries has led to a similarly swift escalation in associated gambling problems.     

An Assessment of the Psychometric Properties of Lithuanian Versions of DSM-IV-MR-J and SOGS-RA

Objective: Since no Lithuanian instrument focuses specifically on the measurement of pathological gambling in adolescence, we aimed to adapt commonly used international instruments (SOGS-RA, DSM-IV-MR-J) and assess their psychometric properties. Methods: Cross-cultural adaptation of DSM-IV-MR-J and SOGS-RA was performed in several steps including translations, synthesis of translations, back-translations, expert committee review, and pre-testing. Adapted instruments were administered to randomly selected adolescents in grades V through XII from all schools in the second largest Lithuanian city (Kaunas). Results: The DSM-IV-MR-J identified 4.2% of the representative sample as pathological gamblers, whereas the SOGS-RA generated prevalence of 5.2%. Cronbach’s alpha for DSM-IV-MR-J in this sample was 0.80 and 0.75 for the SOGS-RA. The correlation coefficient between the SOGS-RA and the DSM-IV-MR-J was statistically significant (Pearson correlation = 0.892, P < 0.001). Using the DSM-IV-MR-J as the baseline for pathological gambling in adolescence, the overall classification accuracy of the SOGS-RA was judged to be adequate, correctly identifying 34 out of 35 pathological gamblers (Kappa = 0.833, P < 0.001). Conclusions: The Lithuanian versions of DSM-IV-MR-J and SOGS-RA exhibited acceptable validity and reliability. The DSM-IV-MR-J was found to be a more conservative measure of pathological gambling.     

Lifetime of Prevalence and Risk Factors of Problem and Pathologic Gambling in North Cyprus

In this article, the results of the national survey of adult gambling behavior in North Cyprus (NC) in 2012 are presented. The aim of this study is to investigate the characteristics of adults’ participation in gambling, and to determine the prevalence of ‘problem and pathological gambling’ in NC. The population of this study was formed from all the people living permanently in NC, speaking Turkish, and within the age group 18–65. Household interviews were conducted with 966 people. To obtain data, a 30 item questionnaire prepared by the researchers and a Turkish version of the Revised South Oaks Gambling Screen were used. Prevalence rates are compared with the results of the study conducted in 2007 using the same methodology and survey form. The lifetime prevalence of participating at least once in any of the 17 gambling activities investigated in the survey was 66.4 %. 3.5 % of the respondents scored as lifetime probable pathological gamblers and 9.2 % as probable problem gamblers. Risk factors for becoming probable problem and pathological gamblers include being male, being in the 19–28 age group, having a high education level, having a job and being born in Cyprus. This study shows that the prevalence of problem gambling is high in NC and increasing gradually. NC has socio-cultural features such as a history of colonization, socioeconomic problems and high unemployment, similar to other high prevalence gambling regions, which is suggestive of the importance of socio-cultural factors on gambling behavior.     

The medical model of pathological gambling: Current shortcomings

Occasional, regular and pathological gambling are distributed in the population as a continuum. Failure to find categorical features of pathological gambling weakens the medical model for this condition, and the implications of this model concerning treatment, both in relation to the possibility of controlled gambling as an acceptable goal, and as to the effectiveness of social manipulations, such as restrictions of gambling outlets. Differences in gambling behavior patterns between pathological and nonpathological gamblers has not been consistently demonstrated and though some support exists for a relationship between addiction to gambling and alcohol, this could be accounted for by other factors than an addiction-prone personality. While findings support a relationship between personality variables and pathological gambling, the concept of a single personality type associated with the behavior seems unlikely. Nevertheless, evidence of physiological differences between pathological gamblers and controls has recently been reported and if established would provide strong support for a medical model, particularly one which allows for an interaction of physiological and sociological factors resulting in dimensional distribution of gambling behaviors.