Self-Directed Gambling Changes: Trajectory of Problem Gambling Severity in Absence of Treatment

Most problem gamblers do not seek formal treatment, recovering on their own through cognitive re-appraisal or self-help strategies. Although barriers to treatment have been extensively studied, there is a paucity of research on self-directed changes in problem gambling and very few studies have examined these changes prospectively. The aim of this study was to examine the trajectory of gambling severity and behavior change over an 18-month period, among a sample of non-treatment seeking/attending problem gamblers recruited from the community (N?=?204) interested in quitting or reducing gambling. Separate mixed effects models revealed that in absence of formal treatment, significant reductions in gambling severity, frequency, and amount gambled could be observed over the course of a 6 to 9-month period and that changes experienced within the first 12 months were maintained for an extended 6 months. Problem gambling severity at baseline was significantly associated with changes in severity over time, such that participants with more severe gambling problems demonstrated greater reductions in their gambling severity over time. A total of 11.1% of participants gambled within a low-risk threshold at 18 months, although 28.7% of the sample reported consecutive gambling severity scores below problem levels for the duration of 1 year or longer. The findings suggest that among problem gamblers motivated to quit or reduce their gambling, significant self-directed changes in gambling severity can occur over a relatively short time. Additional prospective studies are needed to document the role of specific self-help tools or thought processes in exacting gambling changes.     

Adolescent Gambling: Understanding the Role of Stress and Coping

The central variables of stress, coping, and gambling severity were examined along three lines of inquiry. The first addressed whether adolescents with gambling problems reported a greater number of minor or major stressful (i.e., negative) life events relative to others. The second examined whether more with gambling problems employed less-effective coping styles, such as those characterized as less task- or solution-focused, and more emotion- or avoidance-focused coping. Finally, the third question explored whether adolescents’ coping styles mediated the association between stress and gambling severity. Ranging from 11 to 20 years of age, 2,156 high-school students completed instruments assessing gambling involvement, gambling severity, stressful life events, and coping styles. Results indicated that, overall, adolescents with gambling-related problems reported more negative life events relative to social gamblers and non-gamblers. When negative life events were further separated into major and minor events, results revealed that problem gamblers reported more major negative life events but not more minor negative life events relative to others. Results indicated that adolescents with gambling-related problems used less task-focused coping, and more avoidance-focused coping. Males, but not females, who experience gambling-related problems reported using more emotion-focused coping strategies. Finally, emotion-oriented coping was found to mediate the relationship between negative life events and gambling severity. Implications and directions for future research are discussed.

Gambling and Adverse Life Events Among Urban Adolescents

This study explored the cross sectional association between adverse life events and gambling in a sample of 515 urban adolescents (average age 17, 55% male, 88% African American). Approximately half of the sample had gambled in the past year (51%); 78% of the gamblers gambled monthly and 39% had a gambling-related problem. On the other hand, 88% of the sample had experienced at least one life event in the past year, and those experiencing events tended to live in more disadvantaged neighborhoods. The mere acknowledgement of experiencing a stressful life event in the past year (yes/no) was not associated with an increase in odds of being a gambler, with gambling more frequently, or with having a gambling problem. However, when the context of the event was considered, an association was found between directly experiencing threatening and deviant/violent types of events and frequent gambling (OR > 2). Additionally, the probability of being a gambler increased as the number of events experienced increased (aOR = 1.07, 95% CI = 1.01, 1.13, P = 0.013), but problems among gamblers were not associated with the number of events experienced (aOR = 1.01, 95% CI = 0.92, 1.11, P = 0.876). During adolescence, life events appear to be connected more with the frequency of gambling rather than with problems related to gambling.     

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

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

Pathways and transitions of gamblers over two years

Moderate-risk and problem gamblers represent 1.4% and 0.4% of the Québec population, respectively. Research on gamblers’ trajectories has been hampered by methodological shortcomings leading to heterogeneous results. The present research was conducted in the Province of Québec with a representative sample of adult gamblers and aims to explore how gamblers change over time according to the severity of their gambling problems. Using a 2-year follow-up prospective design (3 waves), 179 gamblers selected from a representative survey were divided into the 4 PGSI (Problem Gambling Severity Index) categories. Beyond the decreasing trend in PGSI scores detected within the overall sample using a linear growth model, our analyses revealed that moderate-risk gamblers are heterogeneous in their composition and evolution, comprising stable moderate-risk, recent cases and former problem gamblers. Over three waves, one-third of moderate-risk gamblers improved, one-third remained stable and one-third became problem gamblers. The subgroups transitioning in and out of the moderate-risk category differed in terms of reported changes in gambling behaviours and consequences. Problem gamblers remain vulnerable over time, being at risk of experiencing chronic problems. Results highlight the necessity of subgroup-specific prevention programmes and treatment services that address both the non-linearity of risky gambling and the chronicity of problem gambling.     

Gambling and other risk behaviors on university campuses

To examine the prevalence of problem gambling and its relationship to other risk-taking behaviors, the authors surveyed 1,350 undergraduates at the 4 campuses of Connecticut State University (CSU) during fall 2000. On the basis of a modified version of the South Oaks Gambling Screen, a widely used screening instrument, they found that 18% of the men and 4% of the women reported that gambling had led to at least 3 negative life consequences (eg, felt guilty, gambled more than intended), commonly defined as problem gambling. Students identified as problem gamblers, compared with other students, were significantly more likely to be heavy drinkers, report negative consequences of alcohol consumption, and be regular tobacco and marijuana users. Problem gambling was related to binge eating and greater use of weight-control efforts. University athletes were also found to have significantly greater problem gambling rates than nonathletes. The majority of students gambled but experienced few of the negative consequences reported by problem gamblers.     

‘Got to gamble,but I’ve got no money.’ A qualitative analysis of gambling careers in South Italy

With its geographical differences, Italy provides an interesting case study for analysing the cultural and contextual origin of gambling-related problems. By investigating gambling careers, the study sought to scrutinize the interplay between the personal and environmental factors – including social and cultural aspects – that influence changes in gambling habits among gamblers in Naples (South Italy). The convenience sample consisted of 42 problem and recreational gamblers, male and female, aged between 23 and 71 years, with different employment status and educational level. Results clarify how Neapolitans’ gambling habits have moved towards individualization over time, how availability contributes to increasing gambling in various ways, and how employment status and concerns about money can increase the risk of gambling-related problems, thereby increasing socio-economic inequalities. Confirming previous studies, the study casts doubt on the idea that problem gambling is a chronic and progressive disease, and suggests that periods of excessive gambling can be followed by periods of regulated activity, even without turning to formal treatment. However, life events – either positive or negative – can hinder attempts to regulate gambling.     

The Relationship Between Problem Gambling and Attention Deficit Hyperactivity Disorder

Recent studies indicate that treatment-seeking problem gamblers display elevated rates of ADHD and that adolescents who screen positive for ADHD are more likely to engage in gambling, develop gambling problems, and experience a greater severity in gambling problems. This study aimed to (a) compare the prevalence of ADHD in treatment-seeking problem gamblers to the general population; (b) investigate the relationships between ADHD and problem gambling severity, cluster B personality disorders, motor impulsivity, alcohol use, substance use, gender, and age; and (c) investigate the degree to which these factors moderate the relationship between ADHD and problem gambling severity. Participants included 214 adults (154 males, 58 females, 2 unspecified) who sought treatment for their gambling problems at a specialist gambling agency in Melbourne, Australia. Almost one-quarter (24.9 %) of treatment-seeking problem gamblers screened positively for ADHD, which was significantly higher than the 14 % prevalence in a community sample. ADHD was significantly positively correlated with problem gambling severity, motor impulsivity, and cluster B personality disorders, but was not associated with alcohol and substance use, gender or age. None of the factors significantly moderated the relationship between ADHD and problem gambling severity. These findings suggest that a considerable proportion of treatment-seeking problem gamblers report ADHD and that their clinical profile is complicated by the presence of high impulsivity and cluster B personality disorders. They highlight the need for specialist gambling agencies to develop screening, assessment, and management protocols for co-occurring ADHD to enhance the effectiveness of treatment.     

Male gamblers – suicide victims and living controls: comparison of adversity over the life course

The objective of this research is to investigate the possible difference in accumulation of adversity over the life course among decedent gamblers and living control gamblers in the province of Quebec, Canada. A sample of 90 adult men, 41 living participants and 49 suicide decedents, met the criteria for at-risk and problem gambling over the last five years. Data were obtained from informants in the case of suicide and directly from living controls during semi-structured face-to-face interviews using SCID I and II, SOGS, Module K and a recount of life trajectories methodology. The results showed a high level of adversity throughout the life trajectories of both groups. However, the living gamblers faced more difficulties during their lifespan than the suicide victims. In the last six months before their death, suicide victims had a significantly higher number of mental health disorders, especially co-morbid mental health disorders and anxiety, compared to the living controls. We also observed a rapid escalation of difficulties, more life events and more psychological distress in the last six months of their lives among the suicide decedents. Suicidal behaviour needs to be carefully investigated by medical staff and mental health practitioners, especially when gamblers demonstrate evidence of mental health disorders or financial difficulties.     

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

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

Predicting gambling behaviour and problems from implicit and explicit positive gambling outcome expectancies in regular gamblers

Outcome expectancies are the positive or negative effects that individuals anticipate may occur from engaging in a given behaviour. Although explicit outcome expectancies have been found to play an important role in gambling, research has yet to assess the role of implicit outcome expectancies in gambling. In two studies, we investigated whether implicit and explicit positive gambling outcome expectancies were independent predictors of gambling behaviour (i.e. amount of time spent and money risked gambling; Study 1) and problem gambling severity (Study 2). In both studies, implicit positive gambling outcome expectancies were assessed by having regular gamblers (N = 58 in Study 1; N = 96 in Study 2) complete a gambling outcome expectancy reaction time (RT) task. A self-report measure of positive gambling outcome expectancies was used to assess participants' explicit positive gambling outcome expectancies. Both the RT task and self-report measure of positive gambling outcome expectancies significantly contributed unique as well as shared variance in the prediction of self-reported gambling behaviour (Study 1) and problem gambling severity (Study 2). Findings from the current research point to the importance of using both direct and indirect assessment modes when examining the role of outcome expectancies in gambling.     

Self-generated motives for gambling in two population-based samples of gamblers

In the present study, self-generated responses to a question regarding reasons for gambling from two epidemiological surveys were combined and placed into another earlier motivational model for alcohol use, adapted for gambling. Of the 3601 reasons, 954 could be categorised into the model's categories: (a) coping motives (internal, negative reinforcement); (b) enhancement motives (internal, positive reinforcement); and (c) social motives (external, positive reinforcement). Results indicate that coping gamblers experienced greater gambling severity and psychopathology, enhancement gamblers were most likely to gamble while intoxicated and social gamblers were more likely to choose socially-related gambling. An examination of remaining motives suggests additional categories may be warranted – specifically financial and charitable reasons. These findings offer some support for the model; however, it may need to be expanded to account for other motives. The study highlights the advantages and limitations of using self-generated reasons to study gambling motivation.     

The Self-Regulation of Gambling

Despite the prevalence of gambling world-wide, relatively few individuals become problem gamblers. Additionally many problem gamblers recover without professional assistance. The current study aim was to examine how individuals self-manage their gambling through (a) assessing frequency of use of a range of self-regulation strategies (b) examining how these strategies cluster and (c) exploring relationships between strategies, gambling frequency, amount spent and problem gambling severity. A sample of 303 gamblers was recruited, over-sampling for problem gamblers as assessed by the Problem Gambling Severity Index (PGSI) of the Canadian Problem Gambling Index (mean age 26.4 years, SD = 10.1 years; 119 males, 184 females; 238 social gamblers, 63 problem gamblers, 2 unclassified). They rated extent of usage of 27 gambling self-management techniques and completed the PGSI and other gambling measures. Factor analysis of items produced five factors, named Cognitive Approaches, Direct Action, Social Experience, Avoidance and Limit Setting. The relationships between these factors and key gambling variables were consistent with hypotheses that problem gamblers trying to reduce their gambling would be more likely to use the strategies than other gambler groups. The potential for developing the factors into a Gambling Self-regulation Measure was explored.     

Breaking Bad: Comparing Gambling Harms Among Gamblers and Affected Others

This article examines gambling harms from both gamblers and affected others’ perspectives. Participants (3076 gamblers and 2129 affected others) completed a retrospective survey that elicited information on harms they experienced from gambling across their lifetime. Their responses were analyzed through testing measurement invariance, estimating item-response theoretic parameters, calculating percentages, confidence intervals, and correlations, as well as regressions. The results indicated large commonalities in the experience of harms reported by gamblers and affected others. Further, gamblers appeared to ‘export’ about half of the harms they experienced to those around them. The findings also provided detailed profiles of evolving harms as problem gambling severity varies.     

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.     

Me,myself and money: having a financially focused self-concept and its consequences for disordered gambling

The article describes a test of the hypothesis that some people’s self-concept is overly focused on financial success and that this focus contributes to disordered gambling. Study 1 reported on the development and validation of the Financially Focused Scale (FFS) with a sample of community gamblers (N = 197). As predicted, participants whose self-concept was financially focused attached greater importance to the money they possess as a domain of self-worth. They also indicated that the money they possess is a more important domain of self-worth relative to other life domains. Importantly, greater financial focus was a positive predictor of disordered gambling severity and did so over and above other known predictors of disordered gambling severity (i.e. personal income, Big-Five personality domains, global self-esteem, personal relative deprivation and materialism). Study 2 (N = 220) replicated and extended the findings of Study 1 by examining the motivational mechanisms that may link being financially focused with disordered gambling severity. As hypothesized, monetary gambling motives mediated the relationship between participants’ FFS scores and disordered gambling severity. Having a financially focused self-concept may play a critical role in the development and maintenance of disordered gambling. Addressing this self-concept in treatment may help alleviate gambling disorder.     

Self-stigma coping and treatment-seeking in problem gambling

Stigma has been explored as a cause of reduced and delayed treatment-seeking for problem gambling, a population in which only 1 in 10 seek treatment. The present study examined the effect of perceived public stigma and self-stigma on affect and behavioural coping efforts. Path analysis was used to examine self-stigma in 155 individuals with gambling problems. The majority of participants met criteria for a gambling disorder (93.5%), were current gamblers (69%) and had never sought treatment (54.2%). The data fit the proposed path model well; self-stigma was associated with reduced self-esteem and increased shame. Shame predicted use of secrecy and withdrawal coping. Endorsement of negative stereotypes of ‘problem gamblers’ was associated with decreased treatment-seeking while greater self-stigma predicted increased treatment-seeking. Additional predictors of increased treatment-seeking included greater gambling problem severity, more positive attitudes towards treatment, male sex and higher income. Self-stigma increased rather than decreased treatment-seeking in this analysis. Efforts to increase treatment-seeking could target women, those with lower income and those with less severe gambling problems.     

Examining the effects of gambling-relevant cues on gambling outcome expectancies

There is a consensus in the addictions literature that exposure to addiction-relevant cues can precipitate a desire to engage, or actual engagement, in the addictive behaviour. Previous work has shown that exposure to gambling-relevant cues activates gamblers’ positive gambling outcome expectancies (i.e. their beliefs about the positive results of gambling). The current study examined the effects of a new, arguably more ecologically valid cue manipulation (i.e. exposure to a gambling lab environment vs. sterile lab environment) on 61 regular gamblers’ explicit and implicit gambling outcome expectancies. The authors first tested the internal consistency of their implicit reaction time measure of gambling outcome expectancies, the Affective Priming Task. Split-half reliabilities were satisfactory to high (.72 to .88), highlighting an advantage of this task over other characteristically unreliable implicit cognitive measures. Unexpectedly, no predicted between-lab condition differences emerged on most measures of interest, suggesting that peripheral environmental cues that are not the focus of deliberate attentional allocation may not activate positive outcome expectancies. However, there was some evidence that implicit negative gambling outcome expectancies were activated in the gambling lab environment. This latter finding holds clinical relevance as it suggests that presenting peripheral gambling-related cues while treating problem gamblers may facilitate processing of the negative consequences of gambling.     

Problem gambling,familial violence and alcohol misuse: exploring the triad for treatment-seekers

Research into the co-occurrence of problem gambling, familial violence, and alcohol misuse is limited. While these issues have been considered in combination (i.e. violence and alcohol misuse, problem gambling and alcohol misuse, problem gambling and violence), within Australia, in particular, there has been an absence of exploration of this triad. The current research attempts to fill the gap in the literature, to establish whether there is any difference between problem gamblers with co-occurring violence and problem gamblers who had not experienced violence in terms of their alcohol misuse and gambling behaviours. Interviews were conducted with 81 treatment-seeking problem gamblers to explore how a history of victimization only, perpetration only, victimization and perpetration, or no history of family violence impacted on gambling behaviours (including baseline Victorian Gambling Screen), as well as alcohol misuse. Results indicated that in this treatment-seeking sample there were no significant differences for gambling behaviours or alcohol misuse between problem gamblers with issues of violence and those without. Males demonstrated (on average) a greater tendency toward hazardous drinking or disordered alcohol use. It would be prudent for treatment services to routinely examine problem gamblers' history of violence and alcohol misuse until research verifies the nature of this triad.     

Life course analysis of gambling trajectories: an Indigenous Australian study

Traditional card gambling is a culturally acceptable recreational activity for generations of Indigenous Australians. Commercial gambling activities are popular as well. This study drew on a life course approach and a sample of 57 Indigenous Australian people to examine their gambling trajectories over time that resulted in recreational gambling or in disordered gambling. To gain in-depth insight into various gambling trajectories, this study used an interpretative phenomenological methodology. At early childhood, teenage, young adult and mature adult stages, major gambling influences appeared as dependence, independence, timing of major shifts and transitions, and rationalization, respectively. The study showed that being a recreational or disordered gambler was a shifting or fluctuating position, subject to transitions and events in people's lives rather than a one-way path in either direction. Within a complex cultural environment, the dynamic interplay between social density, context and individual choice appears to influence gambling trajectories for these Indigenous Australians.