Does Providing Extended Relapse Prevention Bibliotherapy to Problem Gamblers Improve Outcome?

Relapse rates among pathological gamblers are high with as many as 75% of gamblers returning to gambling shortly after a serious attempt to quit. The present study focused on providing a low cost, easy to access relapse prevention program to such individuals. Based on information collected in our ongoing study of the process of relapse, a series of relapse prevention booklets were developed and evaluated. Individuals who had recently quit gambling (N = 169) were recruited (through media announcements) and randomly assigned to a single mailing condition in which they received one booklet summarizing all of the relapse prevention information or a repeated mailing condition in which they received the summary booklet plus 7 additional booklets mailed to them at regular intervals over the course of a year period. Gambling involvement over the course of the 12-month follow-up period, confirmed by family or friends, was compared between the two groups. Results indicated that participants receiving the repeated mailings were more likely to meet their goal, but they did not differ from participants receiving the single mailing in frequency of gambling or extent of gambling losses. The results of this project suggest that providing extended relapse prevention bibliotherapy to problem gamblers does not improve outcome. However, providing the overview booklet may be a low cost, easy to access alternative for individuals who have quit gambling.     

Are Psychology University Student Gamblers Representative of Non-university Students and General Gamblers? A Comparative Analysis

Students recruited from psychology undergraduate university populations are commonly used in psychology research, including gambling studies. However, the extent to which the use of this subpopulation produces findings that can be extrapolated to other groups is questionable. The present study was designed to compare results from university-recruited psychology student gamblers to those obtained from a sample of gamblers recruited from the general population that also included students. An online survey measuring gambling behavior and Internet gambling, attitudes and knowledge about gambling and problem gambling severity was posted on websites accessed by gamblers. Participants were recruited from two sources, a psychology undergraduate university population (n = 461) and online websites (n = 4,801). Results showed university-recruited students differed significantly from both adults and students recruited from the general population in respect to demographic variables and gambling behavior. Psychology undergraduate students were younger, more likely to be female, and had lower incomes. When relevant demographic variables were controlled, psychology undergraduate students were found to gamble less frequently, at different times, and to be at lower-risk for gambling-related problems, but had more irrational beliefs and more negative attitudes towards gambling than gamblers recruited from the general population. Results suggest that caution should be used in extrapolating findings from research using university-recruited psychology student gamblers to wide community populations due to differences related to gambling thoughts, attitudes and behaviors.     

Effects of Affective and Anxiety Disorders on Outcome in Problem Gamblers Attending Routine Cognitive–Behavioural Treatment in South Australia

This study evaluated the influence of 12-month affective and anxiety disorders on treatment outcomes for adult problem gamblers in routine cognitive–behavioural therapy. A cohort study at a state-wide gambling therapy service in South Australia. Primary outcome measure was rated by participants using victorian gambling screen (VGS) ‘harm to self’ sub-scale with validated cut score 21+ (score range 0–60) indicative of problem gambling behaviour. Secondary outcome measure was Work and Social Adjustment Scale (WSAS). Independent variable was severity of affective and anxiety disorders based on Kessler 10 scale. We used propensity score adjusted random-effects models to estimate treatment outcomes for sub-populations of individuals from baseline to 12 month follow-up. Between July, 2010 and December, 2012, 380 participants were eligible for inclusion in the final analysis. Mean age was 44.1 (SD = 13.6) years and 211 (56 %) were males. At baseline, 353 (92.9 %) were diagnosed with a gambling disorder using VGS. For exposure, 175 (46 %) had a very high probability of a 12-month affective or anxiety disorder, 103 (27 %) in the high range and 102 (27 %) in the low to moderate range. For the main analysis, individuals experienced similar clinically significant reductions (improvement) in gambling related outcomes across time (p < 0.001). Individuals with co-varying patterns of problem gambling and 12 month affective and anxiety disorders who present to a gambling help service for treatment in metropolitan South Australia gain similar significant reductions in gambling behaviours from routine cognitive–behavioural therapy in the mid-term.     

Is Fear to Intervene with Problem Gamblers Related to Interveners’ Gender and Status? A Study with VLT Operators

We assess how video lottery terminal (VLT) operators’ self-perceive their ability to recognize a problem gambler, to what extent they are approached by problem gamblers seeking for assistance, how many detections and interventions they report, and the reasons they give for not intervening with clients who show signs of problem gambling. We also examine how these variables are related to the operators’ gender and status in the establishment. 177 VLT operators anonymously completed a structured questionnaire at the beginning of a responsible gambling training class held in different French-speaking Swiss towns. The operators felt confident in their ability to detect problem gambling behaviors, were rarely approached by problem gamblers seeking assistance, and reported fewer interventions compared to the number of detections. This reluctance to intervene was mainly attributed to the fear of potential negative reactions from the client. Female staff were the most reluctant to intervene and the most fearful of potential negative reactions from the client. Responsible gambling training programs should include coping strategies for dealing with potential negative reactions from clients. Our findings suggest that staff gender and status are two individual characteristics that should be taken into account when planning responsible gambling trainings.     

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.     

Gamblers’ Habits: Empirical Evidence on the Behavior of Regulars, Newcomers and Dropouts

Electronic gambling offers the opportunity to analyze huge and unbiased data sets of automatically recorded actual gambling behavior. This study refers to data on 2,127,887 poker playing identities from the Online Poker Database of the University of Hamburg (OPD-UHH) to analyze three subgroups of gamblers: regulars, newcomers, and dropouts. Their gambling habits over 6 months are analyzed in total, as well as over time. Regulars show a much higher involvement than non-regulars and increase their playing volume slightly over the observation period. Newcomers have a lower involvement than non-newcomers and most of them decrease their playing volume over time. Still, there is a small group of newcomers which increases their playing volume sharply and is, hence, very interesting for the industry as well as for the early prevention of pathological gambling. Dropouts have a higher gambling involvement than newcomers but play less than players who have not stopped stop gambling. Most dropouts also show a decreasing playing volume before dropping out. An analysis of the correlations between different variables of gambling habits shows that most of them reinforce each other, for example: gamblers with a higher total playing time tend to play at more tables simultaneously. Only playing frequency is a moderating variable of gambling involvement.     

Near Miss,Gambler’s Fallacy and Entrapment: Their Influence on Lottery Gamblers in Thailand

Near miss, gambler’s fallacy and entrapment are hypothesized to influence gambling behavior but their individual impact on gambling behavior and their relationships have not been investigated. This study examines the direct and mediated effects of near miss, gambler’s fallacy and entrapment on lottery gambling among Thai lottery gamblers. Two groups of 200 lottery gamblers participated in the study. One group used superstitious methods to search for lottery numbers to bet, whereas the other group simply bought their tickets from lottery stalls. The superstitious group shows higher levels of near miss, gambler’s fallacy, entrapment and lottery gambling. Three models of relationships among near miss, gambler’s fallacy, entrapment and lottery gambling were constructed using LISREL program. The model that shows a direct effect of near miss, and one that shows a mediated effect of near miss fit the data equally. The results confirm a gambler’s fallacy and entrapment as starting points in the theory of cognitive psychology of lottery gambling and the generalization of near miss in gambling motivation.     

GPs and Problem Gambling: Can they Help with Identification and Early Intervention?

General Practitioners (GPs) are well placed to identify problem gamblers and provide early intervention. To date there is no evidence to suggest that GP’s are routinely screening patients for potential gambling problems. This paper discusses the prevalence of problem gambling, the links with other health problems and ways that GPs can assist. Results from a pilot project that provided educational resources to GPS are also discussed. Suitable screening tools are available that could easily be used by GPs to assess the possibility of gambling problems in patients who may be at increased risk but do not seek help. Early identification and intervention may help prevent a gambling habit escalating to a serious problem. More work needs to be done to increase awareness with GPs of the extent of problem gambling in our community and to alert patients to the fact that gambling can affect their health and that GPs can help.     

Pathological Gamblers: Inpatients’ versus Outpatients’ Characteristics

Several researchers and clinicians have questioned the advantages and disadvantages of inpatient and outpatient treatment for people suffering from pathological gambling. This study compares the characteristics of pathological gamblers seeking inpatient and outpatient treatment. A total of 233 pathological gamblers (inpatients = 134, outpatients = 99) participated in the study. Results show that inpatients have more severe gambling problems than those receiving outpatient services. Similar results were obtained on most other related variables such as anxiety, depression, alcohol consumption, and comorbidity. These results are discussed in terms of the costs and benefits of these two treatment modalities.     

Venue Staff Knowledge of Their Patrons’ Gambling and Problem Gambling

In several jurisdictions around the world, venue staff are encouraged to make reasonable attempts to determine whether patrons may be experiencing problems associated with their gambling. Although a number of visible indicators and behaviours are recognised as being indicative of gambling problems, no research has investigated how effective staff might be in identifying problem gamblers in venues. The aim of this field test was to examine the level of patron familiarity amongst staff working in small to moderate-sized venues. Patrons (n = 303) were asked to complete a short survey including the Problem Gambling Severity Index and venue staff were asked to describe their knowledge of the same patrons independently. The results showed that patrons rated as more at risk by staff scored significantly higher on the PGSI, but that point-in-time staff ratings were not sufficiently accurate to allow effective identification of problem gamblers. The importance of using accumulated information over multiple sessions as well as technological monitoring of behaviour was emphasised by these results.     

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.     

Is the Problem of European Citizenship a Problem of Social Citizenship? Social Policy,Federalism, and Democracy in the EU and United States*

The development of supranational (European) social rights, and therefore social citizenship, is undermined by strong, direct relationships between citizens and national welfare states. Social policies contribute to national identities because they entail direct relationships between states and citizens. In well‐developed European welfare states strong relationships between citizens and their member‐states are expected. This may prevent the development of a similar relationship at the European level. The U.S. provides a comparison case, wherein a successful transference of citizenship identity from a lower to higher level has occurred, partly as a result of the building of national‐level social citizenship, at least for certain classes of people. Revolutionary War Pensions provide an example of how social policy influences national identity. The lack of EU‐level social policy precludes the possibility of this type of identity formation. Finally, the interplay of social citizenship and democracy in both cases is explored. T.H. Marshall’s work regarding citizenship as the basis for democracy is used to understand how the inability to create a common social policy in the EU is harmful to democracy.     

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.     

Where Did All the Pathological Gamblers Go? Gambling Symptomatology and Stage of Change Predict Attrition in Longitudinal Research

Attrition can introduce a systematic bias that can negatively affect validity (Cook and Campbell, Quasi-experimentation: design and analysis issues for field settings. Rand McNally, Chicago, 1979). Current longitudinal research in gambling, however, has generally overlooked the reasons for attrition. The current research examined the relationship between pathological gambling symptomatology, stage of change and attrition. Three hundred and seventy-nine participants were contacted 12 months after initially participating in a study on gambling for a follow-up session. Logistic regression revealed those in the contemplation and preparation stages of change reported higher levels of pathological gambling symptomatology and were more likely to drop out of the study compared to those in the precontemplation stage. As predicted, gambling symptomatology mediated the relationship between stages of change and attrition. The implication for longitudinal research on gambling as well as extant findings that have used this methodological approach is discussed.     

Older Adults’ Gambling Motivation and Problem Gambling: A Comparative Study

Gambling participation rates among older adults (65+ years) have been increasing in recent years. Very few studies have compared older and younger gamblers on gambling motivation and problem gambling. This study compared 41 male and 63 female older gamblers (66-87 years; median 73) to 20 male and 85 female younger gamblers (17-34 years; median 20) in New Zealand on gambling involvement, gambling motives and number of gambling related problems in the previous 12 months. The questionnaire included the Gambling Motivation Scale (GMS) and the Revised South Oaks Gambling Screen (SOGS-R) of current problem gambling. There were between-group age differences but no significant gender or gender by age interaction effects. While older adults had significantly lower scores on all the measures, except they gambled more frequently, for both groups frequency of gambling, number of activities, largest amount spent in a single session and all motives were correlated with SOGS-R scores. Preferences for electronic gaming machines and bingo were related to SOGS-R scores for both age groups. Hierarchical regression analysis showed that after statistically controlling for age, gambling involvement and other motives, tension release uniquely predicted SOGS-R scores. For both age groups, increasing severity of problem gambling is more likely to be associated with releasing tension than with winning money or seeking sensation.     

The Temporal Effects of Divorces and Separations on Children’s Academic Achievement and Problem Behavior

This article provides an examination of the effects of the divorce and separation process on children’s academic achievement and problem behavior over time. By using child fixed effects and establishing a baseline period that is four or more years prior to a family disruption, I can examine how children are affected in different periods relative to the disruption and whether any negative effects subside, persist, or escalate as time passes from the disruption. With a sample of 7- to 14-year-olds, I find that children are affected at least two to four years before the disruption; reading test scores are most affected; and for reading comprehension, the negative effects persist and even escalate as time passes from the disruption.     

Predictability in Pathological Gambling? Applying the Duplication of Purchase Law to the Understanding of Cross-Purchases Between Regular and Pathological Gamblers

The objective of this study is to explore the gambling participations and game purchase duplication of light regular, heavy regular and pathological gamblers by applying the Duplication of Purchase Law. Current study uses data collected by the Australian Productivity Commission for eight different types of games. Key behavioral statistics on light regular, heavy regular, and pathological gamblers were computed and compared. The key finding is that pathological gambling, just like regular gambling, follows the Duplication of Purchase Law, which states that the dominant factor of purchase duplication between two brands is their market shares. This means that gambling between any two games at pathological level, like any regular consumer purchases, exhibits “law-like” regularity based on the pathological gamblers’ participation rate of each game. Additionally, pathological gamblers tend to gamble more frequently across all games except lotteries and instant as well as make greater cross-purchases compared to heavy regular gamblers. A better understanding of the behavioral traits between regular (particularly heavy regular) and pathological gamblers can be useful to public policy makers and social marketers in order to more accurately identify such gamblers and better manage the negative impacts of gambling.     

Which Diagnostic Criteria are Most Useful in Discriminating Between Social Gamblers and Individuals with Gambling Problems? An Examination of DSM-IV and DSM-5 Criteria

The current study sought to identify which diagnostic criteria for gambling disorder have the greatest ability to differentiate between social and problem gamblers. This study was conducted on a sample of male and female college student athletes across the U.S. (n = 8674). Classification and regression tree analysis represents an appropriate technique when addressing the question of an item’s diagnostic value, as it sequentially selects variables to isolate sets of observations with similar outcomes. The current results suggest that the item related to preoccupation (“Have there been periods in the past year where you spent a lot of time thinking about gambling?”) was the DSM-5 item best able to differentiate between male and female social and problem gamblers in this sample. When considering only the nine criteria retained in the DSM-5, three criteria were identified as key for distinguishing between social and disordered gamblers among men, and one criterion was identified for distinguishing between groups of women. In addition, these results do not support the notion that the illegal acts criterion has a particularly low base rate and found that it can be an important indicator of disordered gambling in a college-aged sample.     

Adolescent Gambling and Problem Gambling: Does the Total Consumption Model Apply?

This study describes the extent and distribution of gambling among Norwegian adolescents. The study assesses whether gambling frequency and expenditures and prevalence of problem gambling are associated both at the individual and aggregate (school) level, and in particular whether the total consumption model applies to gambling behaviour. Data comprised a national representative sample of 11,637 13- to 19-year-old students in 73 schools (response rate 92.3%). The Lie/Bet Questionnaire and an additional DSM-criterion on chasing the losses were applied to assess problem gambling. A majority (78.5%) had gambled during the last year and 3.1% met all three criteria for problem gambling. Gambling frequency and expenditures were much higher among problem gamblers and increased proportionally with the degree of problem gambling. The 6.1% who scored on both Lie/Bet items accounted for 59% of all gambling expenditures on slot machines. Positive and significant correlations between various indicators of problem gambling and the overall amount of gambling at the aggregate (school) level imply that the higher the overall amount of gambling and gambling expenditures are, the higher the prevalence of problem gambling, which indicates that the total consumption model also applies to gambling behaviour among adolescents.