Impulsivity,compulsivity and pathological gambling: an exploratory study of pathological gambling as an impulsivity-compulsivity spectrum disorder

The current study was conducted to examine pathological gambling as an impulsivity-compulsivity spectrum disorder. University students (N=162) who gambled a minimum of twice monthly completed measures of impulsivity, compulsivity and pathological gambling. Instruments completed included: measures of problem gambling severity (South Oaks Gambling Screen, NORC DSM-IV Screen for Gambling Problems, Canadian Problem Gambling Index, Victorian Gambling Screen), the Padua Inventory, the Barratt Impulsivity Scale and the Tridimensional Personality Questionnaire. Results supported previous research indicating that pathological gamblers had elevated scores on measures of impulsivity and compulsivity, as well as personality factors correlated with these two constructs. Moreover, impulsivity and compulsivity were found to be interrelated as proposed by the impulsivity-compulsivity spectrum model.     

Problem gambling among female prisoners: lifetime prevalence,help-seeking behaviour and association with incarceration

The widespread introduction of electronic gaming machines (EGMs) in Australia has seen problem gambling (PG) rates soar over the past decade. This has been particularly apparent among women, with presentations to gambling help services increasing fivefold, and 90% of them indicating EGMs as the problem. Prisoners represent a group containing the highest PG rate found in any population. Despite a sharp increase in PG among women and the well-established link between offenders and PG, little data exists concerning PG among female prisoners. This study examined lifetime prevalence of PG among female prisoners in South Australia. The Early Intervention Gambling Health Test was administered to 74 female prisoners. Previous help-seeking behaviour and association with incarceration were also examined. Sixty-four percent of respondents indicated PG with one in six reporting they were incarcerated due to PG-related offending. Problem gamblers whose incarceration was related to PG were more likely to indicate they had gambled to try and win money to repay debts than problem gamblers incarcerated for unrelated offending. Given high levels of PG and overall low rates of help-seeking, women’s prisons may provide an opportunity to engage this high-risk population with effective treatment.     

Gambling Participation and Problem Gambling Severity among Rural and Peri-Urban Poor South African Adults in KwaZulu-Natal

Poor South Africans are significantly poorer and have lower employment rates than the subjects of most published research on gambling prevalence and problem gambling. Some existing work suggests relationships between gambling activity (including severity of risk for problem gambling), income, employment status and casino proximity. The objective of the study reported here is to establish the prevalence of gambling, including at risk and pathological gambling, and the profile of gambling activities in two samples of poor South African adults living in a rural and a peri-urban community. A total of 300 (150 male, 150 female) adults in KwaZulu-Natal, South Africa in communities selected using census data, completed the Problem Gambling Severity Index and a survey of socioeconomic and household information, and of gambling knowledge and activity. It was found that gambling was common, and—except for lottery participation—mostly informal or unlicensed. Significant differences between rural and peri-urban populations were found. Peri-urban subjects were slightly less poor, and gambled more and on a different and wider range of activities. Problem and at risk gamblers were disproportionately represented among the more urbanised. Casino proximity appeared largely irrelevant to gambling activity.     

Problem Gambling Inside and Out: The Assessment of Community and Institutional Problem Gambling in the Canadian Correctional System

This paper reports on the results of a multi-site survey of gambling behaviour and gambling problems amongst offenders in correctional institutions in Ontario, Canada, conducted between 2008 and 2011. A total of 422 (completion rate 61.5 %) incarcerated offenders (381 male and 41 female) took part in the study including 301 federal offenders and 121 provincial offenders. Based on the Problem Gambling Severity Index of the Canadian Problem Gambling Index (CPGI/PGSI) the prevalence rate of severe problem gambling was 8.9 prior to incarceration and 4.4 % during incarceration. These numbers are substantially higher than rates found among the general public. Thirty-four percent of the sample reported gambling in prison. Half of those who suffered from gambling problems before incarceration continued to have gambling problems during incarceration. People with problems related to slot machines prior to incarceration reported fewer gambling problems during incarceration compared to other problem gamblers.     

Internet Gamblers Differ on Social Variables: A Latent Class Analysis

Online gambling has gained popularity in the last decade, leading to an important shift in how consumers engage in gambling and in the factors related to problem gambling and prevention. Indebtedness and loneliness have previously been associated with problem gambling. The current study aimed to characterize online gamblers in relation to indebtedness, loneliness, and several in-game social behaviors. The data set was obtained from 584 Internet gamblers recruited online through gambling websites and forums. Of these gamblers, 372 participants completed all study assessments and were included in the analyses. Questionnaires included those on sociodemographics and social variables (indebtedness, loneliness, in-game social behaviors), as well as the Gambling Motives Questionnaire, Gambling Related Cognitions Scale, Internet Addiction Test, Problem Gambling Severity Index, Short Depression–Happiness Scale, and UPPS-P Impulsive Behavior Scale. Social variables were explored with a latent class model. The clusters obtained were compared for psychological measures and three clusters were found: lonely indebted gamblers (cluster 1: 6.5%), not lonely not indebted gamblers (cluster 2: 75.4%), and not lonely indebted gamblers (cluster 3: 18%). Participants in clusters 1 and 3 (particularly in cluster 1) were at higher risk of problem gambling than were those in cluster 2. The three groups differed on most assessed variables, including the Problem Gambling Severity Index, the Short Depression–Happiness Scale, and the UPPS-P subscales (except the sensation seeking subscore). Results highlight significant between-group differences, suggesting that Internet gamblers are not a homogeneous group. Specific intervention strategies could be implemented for groups at risk.     

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.     

Use of online crowdsourcing platforms for gambling research

Crowdsourcing platforms like Amazon’s Mechnical Turk and Crowdflower have been touted to be a cost-effective way to collect large amounts of behavioural data. Across four large-n studies, gambling-related behaviours, tendencies and traits among participants in these labour markets were examined. In Studies 1 and 2, both conducted on Crowdflower, problem gamblers (as measured by the benchmark Problem Gambling Severity Index) comprised 24.5% and 21.9% of participants, respectively. In Study 3, conducted on Mechanical Turk, problem gamblers comprised 9.0% of participants. In Study 4, a two-wave longitudinal study conducted on Crowdflower, problem gamblers comprised 13.5% of participants in wave one and 14.8% of participants in wave two. In Studies 2 and 3, strong convergent associations were demonstrated across various measures of problem gambling tendencies and general gambling involvement. Furthermore, it was demonstrated that gambling was associated with personality traits (impulsivity, sensation-seeking, self-control), risk attitudes, affect, and behavioural risk-taking consistent with previous research. In Study 4, it was demonstrated that measures of problem gambling have acceptable test-retest reliability. Online crowdsourcing platforms appear to offer access to samples with remarkably high proportions of problem gamblers. However, this characteristic means that such samples are not necessarily representative of gambling tendencies among more general populations.     

Cortisol Rise Following Awakening Among Problem Gamblers: Dissociation from Comorbid Symptoms of Depression and Impulsivity

Gambling pathology has been associated with elevated levels of distress, depression and impulsivity. The present investigation assessed whether these behavioral features would be evident among problem gamblers as they are among pathological gamblers. As well, given that gambling has been associated with increased life stress, as an objective index of ongoing distress, elevations of morning cortisol levels were assessed in problem and pathological gamblers relative to recreational gamblers, and their relations to depressive symptoms and impulsivity were assessed. Recreational, problem, and pathological gamblers (N = 140) completed the Beck Depression Inventory and the Barratt Impulsiveness Scale-11, and provided saliva samples at awakening, 30 min, 3.5 h, and 5.5 h afterward. Consistent with the view that problem and pathological gambling are associated with elevated life stressors, the rise of morning cortisol from awakening to 30 min following awakening was greater than in recreational gamblers. Heightened impulsivity was evident among both problem and pathological gamblers, whereas depressive symptoms were only evident among pathological gamblers. In neither instance were these psychological indices related to the morning cortisol rise. Indeed, increased depressive symptoms were not evident among problem gamblers, despite the fact that elevated morning cortisol levels were evident. The elevated morning cortisol rise may be secondary to gambling problems or distress related to gambling problems. Furthermore, the sustained morning cortisol elevations may be indicative of allostatic overload, and could potentially be a harbinger for potential health risks among problematic gamblers.     

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.     

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.     

Behavioral Activation and Inhibition, Negative Affect, and Gambling Severity in a Sample of Young Adult College Students

The prevalence of pathological gambling among college students is increasing. Few studies have directly examined the relation between reward processing and gambling severity while concurrently examining the effects of co-occurring negative affect in this at risk population. This study used Structural Equation Modeling (SEM) techniques to analyze results from an online survey of 352 female and 96 male students age 18-25. Participants completed measures of past year gambling behavior and severity of gambling problems using the Canadian Problem Gambling Index and the Problem Gambling Severity Index. Negative affect and reward processing were measured by the 21-item version of the Depression, Anxiety, and Stress Scales and the Behavioral Inhibition System and Behavioral Activation System (BIS/BAS) scales, respectively. Thirty-five percent of participants reported gambling in the previous 12 months, and 11% had gambling severity scores indicative of "moderate-risk" or "problem gambling." Gambling severity was associated with negative affect. Negative affect, in turn, was correlated with the unitary BIS scale and inversely associated with the BAS reward responsiveness scale. Reward responsiveness was also inversely associated with gambling severity. In the SEM models, the association between reward responsiveness and gambling severity was mediated by negative affect among males but not among females. Potential explanations for these findings and their implications for addressing problem gambling are discussed.     

Defining a threshold of harm from gambling for population health surveillance research

The measurement of harm in the context of non-problem gambling has received little attention from researchers in the field. Using the combined data from six provincial gambling surveys conducted in Canada between 2001 and 2005 (N = 12,285), we compared how different thresholds of defining gambling-related harm impacts prevalence, the relationship with indicators of gambling intensity and the characteristics of non-pathological gamblers who report experiencing below threshold symptoms of problem gambling. Survey items defining harm were drawn from the Problem Gambling Severity Index (PGSI) of the Canadian Problem Gambling Index. Three definitions of harm – reporting one or more problem gambling symptoms, reporting two or more problem gambling symptoms and having a PGSI score ≥ 3 – demonstrated a strong relationship with indicators of gambling intensity, and reliably differentiated low-threshold and zero symptom problem gamblers in terms of gambling characteristics and other risk factors.     

Characteristics of Older Adult Problem Gamblers Calling a Gambling Helpline

Background Few investigations have characterized groups of older adults with gambling problems, and published reports are currently limited by small samples of older adult problem gamblers. Gambling helplines represent a widespread mechanism for assisting problem gamblers to move into treatment settings. Given data from older adult problem gamblers in treatment, we hypothesized that older as compared with younger adult problem gamblers calling a gambling helpline would be less likely to report gambling-related problems.Design and methods Logistic regression analyses were performed on data obtained from January 1, 2000 to December 31, 2001, inclusive, from callers with gambling problems (N = 1,084) contacting the Connecticut Council on Problem Gambling Helpline.Results Of the 1,018 phone calls used in the logistic regression analyses, 168 (16.5%) were from older adults and 850 (83.5%) from younger adults. Age-related differences were observed in demographic features, types and patterns of gambling reported as problematic, gambling-related problems and psychiatric symptoms, substance use problems, patterns of indebtedness, and family histories of addictive disorders. Older as compared with younger adult problem gamblers were more likely to report having lower incomes, longer durations of gambling, fewer types of problematic gambling, and problems with casino slot machine gambling and less likely to report gambling-related anxiety, family problems, illegal behaviors and arrests, drug problems, indebtedness to bookies or acquaintances, family histories of drug abuse, and problems with casino table gambling.Conclusions Older as compared with younger adult problem gamblers calling a gambling helpline differ on many clinically relevant features. The findings suggest the need for improved and unique prevention and treatment strategies for older adults with gambling problems.     

Factors Associated with Gamblers: A Population-based Cross-sectional Study of South Australian Adults

Objective To determine, using a random telephone survey, the prevalence of various gambling activities among South Australian adults, the prevalence of adult problem gamblers using the South Oaks Gambling Screen (SOGS) instrument, and to examine the problem gamblers by demographic and health-related risk factors.Method A random representative sample of South Australian adults selected from the Electronic White Pages. Overall, 6045 interviews were conducted (73.1% response rate) using Computer Assisted Telephone Interviewing (CATI) technology.Results Overall, 75.6% (95% CI: 74.5–76.7) of respondents had participated in at least one gambling activity during the last 12 months and 2.0% (95% CI: 1.7–2.4) were identified to be problem gamblers. A wide range of factors was associated with problem gambling at a univariate level, when compared to frequent gamblers. The logistic regression analysis highlighted that problem gamblers were more likely to speak a language other than English, be employed part time and a smoker when compared to frequent gamblers. Problem gamblers were also more likely to have a mental health condition (according to the Kessler 10), have had suicidal thoughts and know of services for gambling problems.Conclusion There is a wide range of characteristics associated with problem gambling in South Australia. All of these factors need addressing during policy development to assist problem gamblers.     

Predicting Problem Gambling in Australian Adults Using a Multifaceted Model of Impulsivity

Impulsivity is a factor that has been linked strongly to problem gambling; however, conceptualization problems have impeded research in this area. Research suggests that there may be as many as five impulsivity subtypes and that some but not all of these subtypes are involved in problem gambling. This cross-sectional and correlational study used the multifaceted UPPS-P Impulsive Behaviour Scale as a predictor of problem gambling in a community (N = 200) sample of Australian adult gamblers. Of the five impulsivity subtypes, negative urgency, positive urgency and sensation seeking were found to be positively related to problem gambling, while lack of premeditation and lack of perseverance were unrelated. Multiple regression analyses revealed that positive urgency and negative urgency were the only significant predictors of problem gambling, suggesting that individuals who have the tendency to act rashly when in a positive or negative mood are more likely to display problem gambling behaviour. The results provide further evidence of the significant role of strong emotions in problem gambling. Further, it appears that problem gambling can be motivated both by the impulsive desire to avoid negative mood states and by the impulsive desire to maintain and enhance positive mood states.     

Gambling Participation and Problems Among Employees at a University Health Center

This study evaluated the frequency and intensity of gambling behaviors among employees at an academic health center. Employees were sent an anonymous questionnaire assessing demographic characteristics, participation in gambling activities, and gambling-related problems. Of the 904 respondents, 96% reported gambling in their lifetimes, with 69% gambling in the past year, 40% in the past two months, and 21% in the past week. The most common forms of gambling were lottery and scratch tickets, slot machines, card playing, sports betting, bingo, and track. Only 1.2% of the sample reported gambling on the internet. Using scores on the South Oaks Gambling Screen, 3.0% of the respondents were classified as Level 2 (or problem) gamblers, and an additional 1.8% were Level 3 (or pathological) gamblers. Compared to Level 1 (non-problem) gamblers, Level 2 and Level 3 gamblers were more likely to be male, single, and employed full-time, and to have lower income and education. About half of the Level 2 and Level 3 gamblers reported interest in an evaluation of their gambling behaviors and treatment interventions. These data suggest the need to screen for gambling problems in health care professionals and to provide gambling-specific treatments.     

Association of Problem Gambling with Type of Gambling Among Italian General Population

The origin of gambling disorders is uncertain; however, research has shown a tendency to focus on specific types of games as a potential important risk factor. The principal aim of this study is to examine the relationships between types of gambling practices and gambling disorder. The data were extracted from IPSAD-Italia^® 2010–2011 (Italian Population Survey on Alcohol and other Drugs), a survey among the Italian general population which collects socio-cultural information, information about the use of drugs, legal substances and gambling habits. In order to identify the “problem gambler” we used the Problem Gambling Severity Index. Three groups are considered in this analysis: no-risk gamblers, low-risk gamblers, moderate-risk/problem gamblers. Type of gambling practice was considered among two types of gambler: one-game players and multi-games players. 1.9 % of multi-game players were considered problem gamblers, only 0.6 % of one-game players were problem gamblers (p < 0.001). The percentage of players who were low and moderate-risk gamblers was approximately double among multi-game players, with 14.4 % low-risk and 5.8 % moderate-risk; compared with 7.7 % low-risk and 2.5 % moderate risk among one-game players. Results of ordinal logistic regression analysis confirmed that higher level of gambling severity was associated with multi-game players (OR = 2.23, p < 0.0001). Video-poker/slot-machines show the highest association with gambling severity among both one-game players and multi-game players, with scores of OR equal to 4.3 and 4.5 respectively. These findings suggest a popular perception of risk associated with this type of gambling for the development of gambling problems.     

A population-level metric for gambling-related harm

Prior estimates of the population-level impact of gambling have relied on economic costings. Recent work has derived disability weights for the Problem Gambling Severity Index, which measure per-person impact of gambling on quality of life on a scale of zero to one. This provided scope for the present study to calculate the ‘burden of gambling harm’, which captures the aggregate impact of harms arising from gambling on quality of life in a population. Gambling-related harm was associated with 101,675 years of life lost in Victoria, Australia: approximately two-thirds that of alcohol use and dependence, and major depressive disorder. Problem gamblers suffer more individually (disability weight = .44) compared to those in moderate (.29) and low (.13) risk categories. Nevertheless, moderate and low-risk gamblers account for 85% of population-level harm, due to greater prevalence of these groups. Overall, the scale of gambling-related harm is large relative to other significant health issues, with milder yet non-negligible harm accruing to a relatively broad segment of the gambling population. The article suggests that the tendency to conflate the (typically low) prevalence of problem gambling with total gambling impact is misleading, and argues for a broader population-health based measure.     

Development of an Indigenous Inventory GMAB (Gambling Motives,Attitudes and Behaviors) for Chinese Gamblers: An Exploratory Study

Scale development in the extant gambling literature has been dominated by pathological gamblers, but the non- or sub-clinical gamblers have been overlooked. Moreover, most scales are predominantly based on Western samples; only a few of the scales have Chinese versions validated with Chinese samples. A rarely explored niche still exists for the development of an indigenous scale for Chinese gamblers. The current exploratory study made the first step towards such a direction by identifying factors through the construction of an indigenous Gambling Motives, Attitudes and Behavior (GMAB) scale for Chinese gamblers. Preliminary items were generated primarily from focus group discussions. The items were administered through a telephone survey in which 791 randomly sampled gamblers participated. Exploratory factor analyses revealed (a) five dimensions of gambling motives, namely, self-worth, monetary gains, sensation seeking, boredom alleviation, and learning; (b) four dimensions of gambling attitudes, namely, luck and fate, attitudes toward negative consequences in gambling, techniques, and superstition; and (c) six dimensions of behavior, namely, impaired control in gambling, gambling involvement, arousal reaction, superstitious behavior, controlled gambling and casino exploration. Implications of the interplay among these factors and future research directions were discussed.