Pathological gambling: Psychosomatic,emotional and marital difficulties as reported by the spouse

Two parallel self-administered surveys were distributed at three conferences of Gamblers Anonymous. One survey was for members of Gamblers Anonymous and the other was for members of GamAnon. Approximately 500 respondents completed the surveys, with 215 having completed the questionnaire for the spouse. This article is a report of some of the data from the spouse's survey. This survey focused on two time periods of the spouse's life — during the desperation phase of the gambler's illness (Custer, 1982) and the phase following a period of abstinence from gambling. Specific areas covered in this report focus on the psychosomatic problems and emotional difficulties encountered by the spouse, marital and familial estrangement, financial management, and the need for mental health services. It is anticipated that some of these needs can be met through training or therapy sessions in professional gambling treatment centers and at Gamblers Anonymous conferences.The work on this spouse survey represents a collective effort to enhance the understanding of the relationship between the pathological gambler and the spouse during the desperation phase of the illness and during recovery. Dr. Lorenz developed and implemented the survey. Yaffee organized the data processing, statistical programming, and analysis of the survey. For dedicated and outstanding assistance, special thanks must be given to our senior research assistants, who prepared the codebook and program for this spouse survey: Maria Ycasiano, Leslav Giermanski, Roger Meier, Raisa Rot and Steven Rubenstein. Thanks must also be given to Norberto Colon, Paula Diamond, Edwin Castro, Abdul Beydoun, and Fallan Rhim for their valuable assistance in entering, checking, and cleaning the data prior to analysis. Appreciation for the program written by Joseph Lautner, to check for misalignments in the data file, and the assistance provided by Deborah Becker on this project, is also gratefully acknowledged. To Dr. Thomas Wesselkamper, Chairman of the Hunter College Science Department, for permission to run this project, and all of the aforementioned research assistants, the authors express their sincere gratitude.     

Pathological gamblers and their spouses: Problems in interaction

Two parallel self-administered surveys were distributed at three conferences of Gamblers Anonymous. One survey was for members of Gamblers Anonymous and the other was for members of GamAnon. Of the approximately 450 respondents, 302 were completed by the compulsive gambler and the spouse (N=151 couples). This article is a report on these 151 couples. The survey focused on two time periods — the gambler's time of torment, a phase spent in plumbing the depths of dread and despair, and the period of recovery following abstinence from gambling. Specific areas covered focus on the gambler's gambling activities, the spouse's awareness of problems, psychosomatic and emotional difficulties of the couple, sexual relationships, children's attitudes, and financial management. The respondents also indicated their need for specific therapy and workshops which could be provided by professional mental health counselors or at Gamblers Anonymous conferences.Based on a paper presented at the Seventh International Conference on Gambling and Risk Taking, Reno, August 22–26, 1987.     

Parents of young gamblers

A study of gambling among juveniles in the United Kingdom reveals that their favorite form of gambling, both in terms of percent participating and amounts spent, is playing Amusement with Prizes (i.e., slot) machines. These machines are widely, freely, and legally available to persons of all ages at amusement arcades, youth clubs, cafes, sports centers, bus and railroad stations, and other public settings. Before 1980, machine gamblers were rare at Gamblers Anonymous meetings. However, since that time, their numbers have increased rapidly, currently representing about half of all new members. Of these, 50% are described as children with the remainder in their late teens or early 20s.The balance of the paper describes the difficulties faced by the parents of these youth and the recent development and objectives of a unique self-help group called Parents of Young Gamblers.Editor's Note: Since this writing, P.O.Y.G. has channeled their energies into lobbying the Home Office to take action that would recognize slot machines as gambling devices, remove them from their present easy access to children, and restrict their availability to licensed Game Clubs where only registered adult members may play. The Home Office recently has agreed to place this matter under consideration.The Reverend Gordon E. Moody, M.B.E., was Secretary of the late (British) Churches' Council on Gambling. In the United Kingdom he is Honorary Founder-Patron of Gamblers Anonymous and Chairman of the Gamblers Anonymous General Services Board. He is Founder of Gordon House (a hostel for single, homeless compulsive gamblers) and Honorary Life Member of the Society for the Study of Gambling.     

The relationship between dissociative-like experiences and sensation seeking among social and problem gamblers

The present study examined the relationships between dissociative experiences, sensation seeking scores, and gambling behavior. On the basis of the frequency of their gambling behavior and responses to the Gamblers Anonymous Twenty Questions, subjects were designated as either problem gamblers (N=30) or social gamblers (N=30).Those designated as problem gamblers responded yes to an average of 12.17 questions on the Gamblers Anonymous Twenty Questions as compared to the social gamblers who averaged 1.90 yes responses. Responses on the Twenty Questions correlated strongly with the frequency of gambling behavior and dissociative experiences. Problem gamblers reported a significantly greater number of dissociative experiences than social gamblers (p<.01). Problem gamblers scored significantly higher than social gamblers on the Total Sensation Seeking Scale, and the Boredom Susceptibility, Experience Seeking, and Disinhibition subscales. Clinical implications and recommendations for future research are discussed.     

Who Are the Anonymous? Involvement and Predictors of Gamblers Anonymous Attendance Among Disordered Gamblers Presenting for Treatment

Gamblers Anonymous is the most widely available form of support for disordered gambling. Although chapters exist worldwide, knowledge of how attendees interact with the program is limited. The present study aimed to investigate involvement in Gamblers Anonymous among attendees, motives for attendance, and overall satisfaction with the program. Furthermore, potential gambling-related predictors of attendance versus deciding not to attend Gamblers Anonymous were investigated. A treatment-seeking sample of disordered gamblers (N?=?512) from São Paulo, Brazil completed a series of self-report measures including an author-compiled Gamblers Anonymous survey. From the sample, 141 gamblers reported attending Gamblers Anonymous over the previous 30 days. An examination of involvement, satisfaction, and motives for attending Gamblers Anonymous was conducted, followed by regression analyses to assess predictors of attendance and satisfaction with the program. The majority of attendees (80%) reported some satisfaction with the program. The most common motive for attending Gamblers Anonymous was related to relapse prevention. Regression analyses revealed that greater gambling severity and number of days gambled were associated with not attending Gamblers Anonymous while giving testimonials was strongly related (OR?=?6.18) to satisfaction with the program. The findings of this study contribute to the literature on Gamblers Anonymous. In particular, that members derive great satisfaction from the program and see it as a way to strengthen their abstinence goals. However, despite high satisfaction, the results also suggest that most members were passively involved in the program. More research that assesses the effectiveness of Gamblers Anonymous as either a stand-alone or adjunct treatment is needed.     

The Four Es of Problem Gambling: A Psychological Measure of Risk

A focus group of Reno area Gamblers Anonymous members identified four psychological traits contributing to risk for problem gambling, including: Escape, Esteem, Excess and Excitement. A panel of four experts authored 240 Likert-type items to measure these traits. By design, none of the items explicitly referred to gambling activities. Study 1 narrowed the field of useful items by employing a quasi-experimental design which compared the answers of Reno area Gamblers Anonymous members (N = 39) to a control sample (N = 34). Study 2 submitted successful items, plus new items authored with the knowledge gained from Study 1, to validation in a random sample telephone survey across Queensland, Australia (N=2577). The final 40 item Four Es scale (4Es) was reliable (α=.90); predicted gambling problems as measured by the Canadian Problem Gambling Index of Severity (PGSI, Ferris & Wynne (2001). The Canadian Problem Gambling Index: Final Report: Canadian Centre on Substance Abuse); and distinguished problem gamblers from persons with alcohol abuse problems. The new scale can provide a basis for further study in harm minimization, treatment, and theory development.     

The treatment model of the guidance center for gamblers and their relatives in Vienna/Austria

Within 8 years, Gamblers Anonymous in Vienna evolved into a guidance center for gamblers and their relatives, with professional aid. It is a non-profit institution and the therapeutic team consists of one psychologist, one social-worker and one psychiatrist. The clients can remain anonymous, but about 90% of them reveal their identity. The treatment model integrating professional therapy and self-help is presented. The reasons we decided to base our work on an addiction model of pathological gambling are explained. All the clients consulting our center in 1990 (N=237) are described according to age, sex, types of gambling, duration of problem gambling, family status, profession, income, debts, and income/debt relationship. Finally, the treatment program of our center is presented.This article is an extension of the special issue on Gambling in Europe edited by Iver Hand, M.D.     

Insurance problems and pathological gambling

A survey of 241 members of Gamblers Anonymous was conducted in order to find out the impact of pathological gambling on the insurance industry and whether Gamblers Anonymous reverses that impact. Fifty-two percent of the respondents cashed in, surrendered, lapsed or had policies revoked for non-payment. Forty-six percent borrowed on or used the cash value of their life insurance policies while gambling. Forty-seven percent admitted to some form of insurance related fraud, embezzlement or arson in connection with their gambling. The cost to the insurance industry was estimated at 66 billion dollars in surrendered policies and 33 billion dollars in fraud. Attendance at Gamblers Anonymous reversed much of this loss as members picked up new policies and engaged in programs of restitution after attendance. A discussion is made of the insurance related activities in terms of the usage of options up to and including suicide. Possible insurance industry responses are presented.     

A Comparison of Hispanic and Anglo Calls to a Gambling Help Hotline

Prevalence studies have found that problem gamblers tend to be non-Caucasians. Nevertheless, information on non-Caucasian gambling patterns and problems is virtually non-existent. Data collected during years 1992–1998 on Hispanic (N = 209) and Anglo (N = 5311) problem gamblers calling the Florida Council on Compulsive Gambling Hotline for help is examined to provide information on one such non-Caucasian group: Hispanics. A sharp difference in the number of Hispanic and Anglo callers was found during this six year period (3.8% Hispanic and 96.2% Anglo). Differences were also found in the likelihood of Hispanics calling about their own problems, having gone for previous help, and types of gambling activities. Similarities were found between the two groups regarding age, marital status, and the three most cited problems caused by gambling: problems with family, inability to pay bills and going into debt. Anglos were significantly more likely to engage in illegal activities for gambling money and problems with job. Group differences caution against using Anglo based prevention and treatment programs with Hispanics populations.     

Really not god: Secularization and pragmatism in Gamblers Anonymous

The paper argues that despite maintaining the image of a twelve-step organization, the central theme of the history of Gamblers Anonymous (GA) in the United States is the increasing secularization of the program of the recovery. The paper documents the increasing secularization and pragmatism of Gamblers Anonymous, as reflected in key documents, despite the spiritual vision of its founding member. The author speculates on why Gamblers Anonymous took a secularized development path. Further research is called for.This research was supported in part by NIAAA post-doctoral grant, 2 T32 AA07240-11, at the Alcohol Research Group (ARG), Berkeley, California. I would like to thank ARG, Mary Phillips, the anonymous reviewers and editor of theJournal of Gambling Studies, Kathy Deierlein, Bob Yamashita, and anonymous members of Gamblers Anonymous. This paper is a revision of one presented at the Fifth National Conference on Gambling Behavior in Duluth, Minnesota during July, 1991.     

Perceptions of the Extent of Problem Gambling Within New Casino Communities

Several recent studies using objective measures have found that the rate of pathological gambling in the U.S. is less than 5%. To determine the general population's perception of the prevalence of pathological gambling, a survey was conducted in seven communities where casinos have recently opened. Of the 1631 respondents who provided an estimate, the mean response was that 16% of the community residents were problem gamblers, more than three times the rate found by studies using specific diagnostic criteria. A regression equation found several demographic and attitudinal items are associated with higher prevalence estimates. In addition, the data support a close to home hypothesis that respondents who have relatives who have experienced problems with gambling will tend to perceive higher rates of problem gambling in the community.     

Casino policies: Have Australians had a fair deal?

The introduction of commercial casinos to Australia in 1973 was arguably the most radical shift of gambling policy in Australia's history. At one level, the risk seems to have been justified, with very little organised public opposition to the promotion of casinos as a catalyst for tourism growth and regional economic development. However, recent events suggest that Australian casino policies have moved to a more politicised stage, a period in which governments could be forced to contend with new conflicts, tensions and contradictions. Now that some of the benefits and costs of casinos have become apparent, it is appropriate to evaluate existing casino policies and trends, and to reconsider other alternatives which might be available. This paper examines the broad social implications of the Australian casino boom, the economic changes which have occurred, and the social and political costs which have begun to surface.This article is an updated and modified version of a paper presented to200-UP; The Third Conference of the National Association for Gambling Studies, July ll–13th 1988, Australian National University.     

The South Oaks Gambling Screen Revised for Adolescents (SOGS-RA): Further Psychometric Findings from a Community Sample

The broad expansion of gambling across North America during the last two decades has generated concern about the extent of gambling and problem gambling in youth, and the need to more accurately monitor it. The South Oaks Gambling Screen-Revised for Adolescents (SOGS-RA) is a promising instrument for screening problem gambling (Winters, Stinchfield, & Fulkerson, 1993) that requires more evaluation. Accordingly, further psychometric analysis of the instrument was conducted as part of a community survey of gambling in a sample of 1,000 male and female youth, aged 12 to 17 years. The analyses extended previous focus by including females, young adolescents, and an evaluation of youth classified as at-risk. Consistent with preliminary findings obtained during scale development, the distribution of item endorsement revealed trends of over-endorsement for some items (e.g., gambled more than intended, felt bad about the amount bet), and under-endorsement for others (e.g., criticized or told you had a gambling problem). These results suggest consideration of some form of weighting procedure, item deletion or re-wording. A factor analysis of the SOGS-RA items suggested a two-factor solution, with one factor interpreted as Control over Gambling and the other Gambling Consequences. It is proposed that the two factors may represent early versus more severe levels of gambling problems, respectively. The results highlight the need for further psychometric evaluation and refinement of instruments used to identify gambling problems in young people.     

Estimating the extent and degree of Gambling related problems in the Australian population: A national survey

A stratified random doorknock method was used to interview 2744 respondents in four state capitals in Australia. The interview was in 3 parts with the latter two only administered to regular, once per week or more often gamblers (N=290). The measures completed by this group included the South Oaks Gambling Screen and a range of psychological measures. A conservative interpretation of the results was that problem gamblers, defined in terms of a range of personal and interpersonal gambling-related costs, comprised 1.16% (±0.34%) of the Australian population. It was estimated that problem players losses may account for about one quarter of all expenditures on gambling.     

Behavior Genetic Research on Gambling and Problem Gambling: A Preliminary Meta-Analysis of Available Data

A meta-analysis of family and twin studies on gambling and problem gambling was initiated in an effort to determine the probable role of genetic factors in high risk wagering. Two twin studies and 17 investigations employing the family history or family study method were included in this meta-analysis. A summation of the 19 studies produced a small but significant overall effect size (weighted = .10, unweighted = .13), with both family (weighted = .12, unweighted = .14) and twin (weighted = .06, unweighted = .05) studies achieving significant individual mean effects. Given the paucity of twin data, further analysis was confined to family studies and revealed a stronger familial effect for the sons of problem gambling fathers than for the daughters of problem gambling mothers and for more severe forms of problem gambling than for less severe forms of problem wagering, and was strongest for high severity problem gambling in males. The implications of these results are discussed.     

The roots,significance, value and legislation of gambling

In this highly personal account, Reverend Moody traces his exploration for over three decades of many facets of the underlying nature of gambling in society and in human nature. He makes the case that much of the appeal of gambling comes from the excitement of playing with chance, and discusses how different types of gambling — lotteries, wagering, and continuous betting — meet a variety of needs and pose diverse levels of risk to gamblers. He notes distinctions between controlled and uncontrolled gamblers, and the tendency for controlled gamblers to play on the edge and risk loss of control. He notes difficulties in preventing the excesses that can occur to individuals who gamble. He points out the problems with legislatures legalizing gambling for ulterior purposes, such as to raise tax revenue, rather than to cater to the demand for gambling from punters. This can lead to situations where commercial gaming interests are not directed to act in the best interests of the general public because potential problems that may arise with available gambling are ignored or deemphasized. Finally, he points out the tensions amongst various interest groups who deal with gambling and notes those forums which have evolved in recent years that provide greater opportunities for dialogue among the various entities who deal with gambling and public policy issues.Gordon Moody was ordained a Minister of the Methodist Church in 1942. In recognition of his work on gambling, he was awarded the M.B.E. (Member of the Most Excellent Order of the British Empire) by the Queen in 1969. In 1980, the Open University conferred on him the Honorary Degree of Master of Arts. (See obituary, pp. 3–7). This issue is dedicated to his memory.     

The prevalence rates of pathological gambling: A look at methods

Planning the gambling environment requires protection of the public's health, safety and welfare. Whereas most public gaming provisions and statutes address the public's fears of organized crime as well as some welfare needs, rarely do they safeguard the public's health regarding the spread of the mental disease known as pathological gambling. Measurement of the prevalence and incidence of this disease would enable policy planners to evaluate both the state's responsibility for an epidemic and the adequacy of publicly funded treatment programs. The purpose of this paper is to examine the methods which underlie three different estimates of the prevalence rate of pathological gambling and to critique them in the light of sound epidemiological procedure. In 1975, the Institute for Social Research (ISR) of the University of Michigan conducted a national survey and a survey of the state of Nevada on behalf of the U.S. Commission on a National Policy Toward Gambling. Using discriminant function analysis coupled with subjective inspection of cases in the at-risk pool, the researchers estimated rates of probable and potential pathological gamblers. In 1984 and 1985, this author surveyed residents in the Delaware Valley and the state of Ohio using the cumulative clinical signs method which also posited rates of probable and potential pathological gamblers. In 1986, researchers at the Office of Mental Health for the State of New York employed a formal screening device to survey residents and proposed a rate of probable pathological gamblers and a rate of problem — although not pathological — gamblers. All three approaches produced different estimates. The utility of prevalence and incidence rate research in this field is threatened by a lack of consensus about the proper epidemiological procedure to be employed in arriving at these estimates. There is also confusion about the distinction between a probable and a potential pathological gambler. The planning purpose, method, validity and reliability of prevalence rate research about pathological gambling are addressed in this paper.     

Evidence for a common dissociative-like reaction among addicts

A questionnaire was designed to test selected aspects of the author's General Theory of Addictions (Jacobs, 1982). Data were collected from groups of compulsive gamblers, alcoholics, and compulsive overeaters, and compared with the responses to the same questionnaire obtained from normative samples of adolescents and adults. The more inclusive term, compulsive gambler, has been used throughout, since the sample of gamblers in this study included an inpatient subgroup who had been diagnosed as pathological gamblers, as well as a subgroup of Gamblers Anonymous members who had not been clinically evaluated. Findings support the author's theoretical position that, when indulging, different kinds of addicts will tend to share a common set of dissociativelike experiences that differentiate them from nonaddicts. This has been termed a state of altered identity.     

Social Class,Cultural Repertoires,and Popular Culture: The Case of Film

This research examines two different conceptions of the relationship between social class and familiarity with popular culture in the United States. Specifically, it focuses on differences between members of the upper-middle class and members of the lower-middle class in terms of their film viewing practices. The data for this analysis was obtained from a survey of 364 individuals randomly selected from two neighborhoods in a medium-sized city, one predominantly upper-middle class and the other predominantly lower-middle class. Members of the upper-middle class view more art films, as well as more classic films and blockbuster films, than members of the lower-middle class. These differences are largely attributable to the fact that members of the upper-middle class view more films both in theaters and on videocassettes than members of the lower-middle class. Moreover, these differences are reduced, but not entirely eliminated, by the fact that members of the lower-middle class view more films on television than members of the upper-middle class. Finally, these differences in the film-viewing practices of the members of these two social classes, as identified by their neighborhood of residence, obtain even controlling for a series of demographic and socioeconomic background variables.