Prevalence of Problem and Pathological Gambling in Parkinson’s Disease

Pathological gambling (PG) has been identified in patients with Parkinson’s disease (PD) treated with dopamine agonists suggesting that dysregulation of brain dopaminergic activity may contribute to the development of gambling problems. The current study was undertaken to further establish the prevalence of problem and PG in patients with PD, identify any clinical correlates, and determine if psychiatric or substance use co-morbidity contributes to the increased prevalence of problem and PG. A cross-sectional survey of 140 serially recruited moderate to severe PD patients was undertaken utilizing the Canadian Problem Gambling Index, Alcohol Use Disorders Identification Test, Drug Abuse Screening Test, Beck Depression Inventory, Beck Anxiety Inventory, and Mini-Mental State Exam augmented by chart review, completed over an 8 month period. The 12 month prevalence of problem and PG in PD was 9.3% compared to 1.6% in the general population within a comparably aged sample. The increased prevalence of problem and PG in the PD group was related to dopamine agonist use and younger age, but not co-morbidity. Most subjects with problem and PG reported their gambling increased after being diagnosed with PD and starting treatment. The results suggest that brain dopaminergic activity is involved in the underlying neurobiology of problem and PG.     

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.     

Using Fear Appeals in Warning Labels to Promote Responsible Gambling Among VLT Players: The Key Role of Depth of Information Processing

Video lottery terminals (VLT) are a highly lucrative gambling format, but at the same time they are among the most hazardous. Previous research has shown that threatening warnings may be an appropriate approach for promoting protective behavior. The present study explores the potential benefits of threatening warnings in the fight against compulsive gambling. A 4 × 2 factorial design experiment was used to test our model based on both Elaboration Likelihood Model and Protection Motivation Theory. 258 VLT adult players (58% males, 42% females) with various degrees of problem gambling were exposed to three threat levels (plus a control condition) from two different sources (i.e., either a medical source or a source related to the provider of VLT’s). Our results show that both higher threat warnings and the medical source of warnings enhance Depth of Information Processing. It was also found that Depth of Information Processing affects positively attitude change and compliance intentions. The theoretical and managerial implications are discussed.     

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.     

Association Between Internet Gambling and Problematic Internet Use Among Adolescents

The study objectives were to evaluate the correlates and psychosocial implications of internet gambling among adolescents, as well as the association between internet gambling and problematic internet use. A cross-sectional study design was applied among a random sample (N = 484) of adolescents (71.2% boys; 28.8% girls; mean age ± standard deviation, SD = 14.88 ± 0.55 years). Self-completed questionnaires, including internet gambling practices, internet use characteristics, Young Internet Addiction Test, and Strengths and Difficulties Questionnaire were utilized. The prevalence of internet gambling was 15.1%. Internet gambling was associated with psychosocial maladjustment, including Abnormal Conduct Problems (gender adjusted odds ratio, AOR = 3.83; 95% confidence interval, 95% CI: 1.86–7.92) and Borderline Peer Problems (AOR = 2.04; 95% CI: 1.09–3.85). The likelihood of concomitant problematic internet use was significantly higher among internet gamblers (AOR = 1.81; 95% CI: 1.03–3.19). Multivariate regression analyses indicated that among all characteristics of internet use assessed, utilizing the internet for the purposes of gambling practices was independently associated with problematic internet use among adolescents (AOR = 3.43; 95% CI: 1.40–8.39). Thus, the study findings suggest that adolescents who participate in internet gambling practices are more likely to concomitantly present with problematic internet use.     

Replication of Low-Risk Gambling Limits Using Canadian Provincial Gambling Prevalence Data

A set of low-risk gambling limits were recently produced using Canadian epidemiological data on the intensity of gambling behavior and related consequences (Currie et al. Addiction 101:570–580, 2006). The empirically derived limits (gambling no more than two to three times per month, spending no more than $501–$100°CAN per year or no more than 1% of gross income spent on gambling) accurately predicted risk of gambling-related harm after controlling for other risk factors. The present study sought to replicate these limits on data collected in three independently conducted Canadian provincial gambling surveys. Dose–response curves and logistic regression analyses were applied to gambling prevalence data collected in surveys conducted in 2001–2002 within the provinces of Alberta, British Columbia, and Ontario (combined sample N = 7,675). A comparable dose–response relationship between gambling intensity and risk of harm was found in each province. The optimal thresholds for defining an upper limit of low-risk gambling were similar across the three provinces despite variations in the availability and organization of legalized gambling opportunities within each region. These results provide additional evidence supporting the validity of the low-risk gambling limits. Quantitative limits could be used to augment existing responsible gambling guidelines.

Twelve-Step Facilitated Versus Mapping-Enhanced Cognitive-Behavioral Therapy for Pathological Gambling: A Controlled Study

This study examined the efficacy of two group treatments for pathological gambling, a node-link mapping-enhanced cognitive-behavioral group therapy (CBGT-mapping) and twelve-step facilitated (TSF) group treatment. Forty-nine participants meeting criteria for pathological gambling were recruited from local newspaper advertisements. These participants were randomly assigned to one of three conditions: TSF (n = 11), CBGT-mapping (n = 18), and Wait-List control (n = 9); 11 refused treatment prior to randomization. Outcome measures included number of DSM-IV criteria met, perception of control/self-efficacy, desire to gamble, and frequency of gambling episodes. Analyses revealed a significant treatment group × time interaction (η2_partial = .39). Specifically, the group treatments resulted in significant improvements in the dependent measures, while the Wait-List group remained relatively stable. Overall, CBGT-mapping and TSF had no significant differences on any outcome measure at follow-up assessments. Analysis of post-treatment and 6-month follow-up reveal a significant improvement in gambling outcomes (i.e., fewer DSM-IV criteria met, greater self-efficacy, and fewer gambling episodes (η2_partial = .35), with treatment gains maintained at 6 months. These results are consistent with previous research for group treatment for pathological gambling and provide support for the utility of TSF and a mapping-based CBT therapy as viable intervention for pathological gambling.     

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.     

Offspring of Parents with Gambling Problems: Adjustment Problems and Explanatory Mechanisms

We compared offspring of problem gamblers (n = 42) to offspring of parents without gambling problems (n = 100) to see (1) whether the two groups differed with respect to depressive feelings and conduct/antisociality problems and (2) whether ineffective parenting or the offspring’s own gambling problems played a mediating role in this context. Participants were drawn from a relatively large community-based study (N = 1,872). Parents rated their own gambling and other mental health problems when their children were in mid-adolescence. The children’s self-reports on depressive feelings and conduct/antisociality problems were assessed at two points in time: by mid-adolescence and again by early adulthood. Results showed that children of parents with gambling problems reported more depressive feelings and more conduct problems by mid-adolescence than children of parents without gambling problems. Children of problem gamblers also experienced an increase in their depressive symptoms from mid-adolescence to early adulthood. Importantly, ineffective parenting, but not children’s gambling problems, mediated almost all the links between parental problem gambling and children’s adjustment problems. These results add to a very small data base showing that children of problem gamblers are at risk for a variety of adjustment 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.     

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.     

Affect-Regulation Expectancies among Gamblers

Factor scores on a gambling expectancy questionnaire (GEQ) were used to subtype 132 university students who gamble regularly (37.9% male; M age = 22.6 years, SD = 6.04) as: Reward Expectancy Gamblers (Reward EGs)—have strong expectations that gambling augments positive mood, Relief Expectancy Gamblers (Relief EGs)—have strong expectations that gambling relieves negative affect, and Non-Expectancy Gamblers (Non-EGs)—have neither strong expectation. Gambling on a high-low card game was compared across subtypes following priming for either “relief” or “reward” affect-regulation expectancies with the Scrambled Sentence Test (SST). The hypothesized Prime type × GEQ subtype interaction was not significant. When a more stringent set of criteria for GEQ subtyping was imposed, the “purified” sub-sample (n = 54) resulted in the hypothesized statistically significant Prime type × GEQ subtype interaction. Relief EGs gambled more after being primed with the construct “relief of negative emotions” compared to after being primed with the construct “augmentation of positive emotion.” Planned orthogonal contrasts showed a significant linear increase in number of bets made across GEQ subtypes when prime type corresponded to GEQ subtype. The results suggest a need for components in gambling treatment programs that address clients’ expectancies that gambling can provide a specific desirable emotional outcome.     

The Efficacy of a Modified Theory of Reasoned Action to Explain Gambling Behavior in College Students

Recently, Thrasher et al. (College Student Affairs Journal 27(1): 57–75, 2007) explored the efficacy of the Theory of Reasoned Action (TRA; Ajzen and Fishbein, Attitudes, personality, and behavior, 1980) in explaining gambling behavior of college students. However, their study found the TRA only predicted small amounts of variance in gambling intentions. Heeding their call to enhance the efficacy of the TRA through the addition of explanatory variables to the model, the present study incorporated gambling motivations and locus of control as moderating variables within the TRA to test the potential of a modified TRA in explaining gambling behavior of college students. A total of 345 students at a major metropolitan research university in the Midwest volunteered to participate in the study. A series of hierarchical linear regressions indicated intrinsic motivation to accomplish (p = .002) significantly moderated the relationship between gambling attitudes and gambling intentions. Further, internal locus of control (p < .001), chance locus of control (p < .001), and powerful others locus of control (p < .001) also significantly moderated the relationship between gambling attitudes and gambling intentions. The significant impact of the moderating variables on the relationship between gambling attitudes and intentions suggests intrinsic motivation and locus of control can alter the impact of the relationship between gambling attitudes and gambling intentions.     

Instant Ticket Purchasing by Ontario Baby Boomers: Increasing Risk for Problem Gamblers

Instant ticket purchase gambling (ITPG) is pervasive in Ontario and has features that mimic slot machine play. Previous researchers have reported that ITPG is one preferred activity for at-risk/problem gamblers. In the general Canadian population, rate of participation in ITPG is second only to lottery ticket gambling. Both are particularly favored by youth and seniors. The next cohort of seniors will be Canada’s baby boomers, one-third of whom live in Ontario. Secondary analysis of Statistics Canada data revealed that adults in this cohort who buy instant gambling tickets (N = 1781) are significantly different from the complete group of their age peers (N = 4266) in number of activities pursued and frequency of involvement. At-risk/problem gambling prevalence was 10.2% amongst Ontario baby boomers who participate in instant ticket gambling, significantly higher than the 6.7% found amongst the total group of baby boom gamblers. For those who reported experiencing one or more of the Canadian Problem Gambling Index indicators for problem gambling (N = 237), 73% were buying instant tickets. Future research should consider cohort effects and explore combinations of preferred gambling activities that may increase risk for problem gambling. Social policy recommendations include the use of all ITPG venues as key locations for promoting awareness of problem gambling treatment services. This work was funded by Ontario Problem Gambling Research Centre.     

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.     

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.     

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

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

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.     

Mahjong Gambling in the Chinese-Australian Community in Sydney: A Prevalence Study

Mahjong is a popular gambling game played in Chinese communities all over the world (Papineau, China Perspect 28:29–42, 2000) and is sometimes referred to as ‘国赌’ (guodu, the Chinese national gambling game) or ‘修长城’ (xiu changcheng, repairing the Great Wall). Exploratory studies using snowball sampling conducted by Zheng et al. (J Psychol Chin Soc 9(2):241–262, 2008) indicated that Mahjong is not only a popular pastime within the Sydney Chinese community but also problematic for around 3% of players. The current study aimed to extend earlier studies by estimating the prevalence of Mahjong problem gambling in a random sample of Sydney Chinese community members. In addition, due to first-hand gambling experience of the first author with superstitious Mahjong players, the study also investigated the role of superstitious beliefs in Mahjong gambling. The current study involved a series of self-report questionnaires administered to 469 randomly selected Chinese Australians in Sydney. The problem gambling rate, assessed by the Canadian Problem Gambling Index (CPGI), was 3.8%, with Chinese males and older Chinese prominent. Superstitious beliefs were found to play a part in the maintenance of Mahjong gambling behaviour. Information stemming from the current study has helped gain insight into culturally specific forms of gambling, and to identify correlates of problem gamblers. Funding bodies and counselling services should be aware of the existence of this form of gambling, and should devise appropriate treatment plans for Mahjong problem gamblers.