Frequent Card Playing and Pathological Gambling: The Utility of the Georgia Gambling Task and Iowa Gambling Task for Predicting Pathology

The current investigation examined performance on two laboratory-based gambling tasks, the Georgia Gambling Task (GGT; Goodie, 2003. The effects of control on betting: Paradoxical betting on items of high confidence with low value. Journal of Experimental Psychology: Learning, Memory, and Cognition, 29, 598–610) and the Iowa Gambling Task (IGT; Bechara, Damasio, Damasio, & Anderson, 1994. Insensitivity to future consequences following damage to human prefrontal cortex. Cognition, 50, 7–15), as well as self-reported markers of gambling pathology using the Diagnostic Interview for Gambling Severity (DIGS; Winters, Specker, & Stinchfield, 2002. The downside: Problem and pathological gambling (pp. 143–148). Reno, NV: University of Nevada, Reno) among a sample of undergraduate students who are frequent card players. Two hundred twenty-one participants (55 female and 166 male; mean age 19.21 years) who self-classified as playing cards at least once per month completed these measures. Performance on GGT and IGT systematically related to gambling-related pathology in several ways. Overconfidence and bet acceptance on the GGT, and myopic focus on reward on the IGT, predicted gambling related pathology. GGT and IGT performance correlated with each other, but both contributed independently to predicting gambling pathology. Card playing frequency predicted gambling pathology but not GGT or IGT performance. Discussion focuses on the role of biases of judgment and risky decision making in pathological gambling.     

Prevalence of Adult Problem and Pathological Gambling between 2000 and 2005: An Update

Background Excessive gambling is a prominent Public Health problem with high prevalence rates in many countries. Substance abuse and other co-morbidities often constitute a major health hazard for the person which gambles with a loss of material and social resources, as well as being a major concern for his or her significant others. The present study updates and extends prevalence data to include work published between 2000 and 2005 in English and other European languages. Methods In a three-step search and exclusion process, studies with current adult prevalence rates were gathered. Results Almost all studies fulfil basic research standards. The weighted mean prevalence rates for excessive gambling (problem and pathological) are 3.0% for the South Oaks Gambling Survey (problem 1.2%; pathological 1.8%), 3.3% for the Canadian Problem Gambling Index (problem 2.4%; pathological 0.8%) and 3.1% for the DSM-IV (problem 1.9%; pathological 1.2%). Conclusion The prevalence rates are comparable and relatively stable between countries and across survey instruments, and do not differ from earlier reviews. The regular epidemiological monitoring of excessive gambling remains a major Public Health issue although the distinction between pathological and problem gambling is not appropriate for epidemiological research. Further studies are needed with respect to concomitant lifestyle characteristics.     

The Iowa Gambling Treatment Program: Treatment Outcomes for a Follow-up Sample

The Iowa Gambling Treatment Program (IGTP) amassed participant data for gamblers and concerned others of gamblers over 4 years (1997–2001). Data collection opportunities included: (1) crisis contacts, (2) placement screening, (3) admission, (4) treatment services, (5) discharge, and (6) follow-up. Among followed gamblers, 74% of treatment completers, 49% of substantial treatment completers, and 36% of dropouts and referrals were abstaining from gambling at 6-month follow-up. The reduction in dollars lost to gambling was similar; 85% of treatment completers, 88% of substantial treatment completers, and 65% of others reduced their dollars lost per week. Although more extensive follow-up efforts are needed to properly evaluate the effectiveness of the IGTP, these results suggest that the IGTP shows promise.     

Treatment of Female Pathological Gambling: The Efficacy of a Cognitive-Behavioural Approach

Given that a substantial proportion of current pathological gamblers are female, it is evident that women are underrepresented in the treatment outcome literature. The current study was designed to redress the limited information on the treatment of female pathological gambling. Although the use of cognitive-behavioural therapy is the most highly recommended approach as ‘best practice’ for the treatment of pathological gambling, no attempt to date has been made to evaluate the efficacy of this approach for female pathological gambling. Nineteen female pathological gamblers with electronic gaming machine problems were treated with a cognitive-behavioural program. While pathological gamblers placed on a waiting list did not show significant improvement on gambling behaviour and psychological functioning measures, the female pathological gamblers showed significant improvement on these measures over the treatment period, and maintained this improvement at the 6-month follow-up evaluation. By the completion of the follow-up period, 89% of participants no longer met diagnostic criteria for pathological gambling. Although further scientific demonstration and replication are required, the outcomes of this study indicate that the therapy that is considered ‘best practice’ in the treatment of pathological gambling is effective for female pathological gambling.     

A Preliminary Investigation of Abstinence and Controlled Gambling as Self-Selected Goals of Treatment for Female Pathological Gambling

The current study aimed to provide a preliminary evaluation of the differential efficacy of a cognitive-behavioural treatment program for female pathological gamblers delivered with the goals of abstinence or controlled gambling. The findings were based on the comparison of pathological gamblers selecting abstinence and pathological gamblers selecting controlled gambling on measures of gambling behaviour and psychological functioning. The findings revealed that pathological gamblers selecting controlled gambling displayed comparable levels of improvement to those displayed by gamblers selecting abstinence. Using a treatment completer approach, 89% of the gamblers selecting abstinence compared with 82% selecting controlled gambling no longer satisfied the diagnostic criteria for pathological gambling by the completion of the 6-month follow-up period. Although further scientific demonstration is required, the findings of this study provide preliminary support for the practice of offering controlled gambling as an alternative goal in the treatment of pathological gambling.     

A Canadian Population Level Analysis of the Roles of Irrational Gambling Cognitions and Risky Gambling Practices as Correlates of Gambling Intensity and Pathological Gambling

Using population data (N = 11,562) drawn from five Canadian gambling prevalence surveys conducted between 2000 and 2005, the current study investigated the relationship between irrational gambling cognitions and risky gambling practices upon (a) gambling intensity, as measured by percent of income spent on gambling and (b) tolerance, a diagnostic indicator of pathological gambling. First, we found irrational gambling cognitions and risky gambling practices to be positively related. Second, irrational gambling cognitions moderated the relationship between risky gambling practices and gambling intensity. Specifically, people engaging in risky practices, spent less of their income on gambling when they had fewer irrational gambling cognitions compared to those with more irrational cognitions. Third, irrational gambling cognitions moderated the relationship between risky gambling practices and tolerance. Of the people engaging in risky practices, those with no irrational cognitions reported lower levels of tolerance than those with at least one irrational cognition. Interactions with gender are reported and discussed. These findings demonstrate the importance of both gambling cognitions and gambling practices upon the intensity of gambling and pathological gambling.

Vulnerability and Comorbidity Factors of Female Problem Gambling

This study helps to address a deficiency of gender-specific research into problem gambling. It focuses on the gambling behaviors, family and personal histories and comorbid psychological disorders of 365 female gamblers from across Ontario, Canada, who responded to a mail-in survey. Specifically, this study looks at rates of depression and anxiety, concurrent struggles with other behaviors (such as alcohol and drug use, disordered eating, overspending and criminal activity) and abuse history reported by female gamblers. The reported rates are considerably higher than for the general female population. The findings of this study agree with previous research. They suggest that prevention strategies and treatment practices for female problem gamblers should take into account women’s mental health, addiction and trauma history as contributing factors in the development of problematic gambling.     

Brief Communications: Gender Differences in Gambling Progression

The authors compared 39 women and 38 men entering an outpatient treatment program for pathological gambling. They were diagnosed according to DSM-IV and selected by SOGS, followed by a semi-structured interview for demography and progression of the gambling behavior prior to treatment. Women were more often single (59% vs. 26%; p = .005) and started gambling significantly later than men (34.2 vs. 20.4 years; p < .001). The progression of the disorder was more than 2 times faster in women than in men. There was no difference in the age of seeking treatment (44.7 vs. 42.3 years). Findings from this study resemble gender differences in other addictions—in particular the faster progression among women—challenge pharmacodynamic hypotheses for this phenomenon, and suggest gender into account when devising treatment strategies for pathological gambling.     

How Do Gamblers End Gambling: Longitudinal Analysis of Internet Gambling Behaviors Prior to Account Closure Due to Gambling Related Problems

Objective: To examine behavioral patterns of actual Internet gamblers who experienced gambling-related problems and voluntarily closed their accounts. Design: A nested case–control design was used to compare gamblers who closed their accounts because of gambling problems to those who maintained open accounts. Setting: Actual play patterns of in vivo Internet gamblers who subscribed to an Internet gambling site. Participants: 226 gamblers who closed accounts due to gambling problems were selected from a cohort of 47,603 Internet gamblers who subscribed to an Internet gambling site during February 2005; 226 matched-case controls were selected from the group of gamblers who did not close their accounts. Daily aggregates of behavioral data were collected during an 18-month study period. Main outcome measures: Main outcomes of interest were daily aggregates of stake, odds, and net loss, which were standardized by the daily aggregate number of bets. We also examined the number of bets to measure trajectory of gambling frequency. Results: Account closers due to gambling problems experienced increasing monetary loss as the time to closure approached; they also increased their stake per bet. Yet they did not chase longer odds; their choices of wagers were more probabilistically conservative (i.e., short odds) compared with the controls. The changes of monetary involvement and risk preference occurred concurrently during the last few days prior to voluntary closing. Conclusions: Our finding of an involvement-seeking yet risk-averse tendency among self-identified problem gamblers challenges the notion that problem gamblers seek “long odds” during “chasing.”     

Treatment Goal Selection for Female Pathological Gambling: A Comparison of Abstinence and Controlled Gambling

The current study was an exploratory investigation of the selection of controlled gambling as a goal of treatment for female pathological gambling. Specifically, it aimed to explore: 1) the popularity of controlled gambling as a goal of treatment; 2) the reasons pathological gamblers select abstinence and controlled gambling as goals of treatment; and 3) the characteristics of pathological gamblers attracted to abstinence and controlled gambling. The sample comprised 85 female pathological gamblers attending a cognitive-behavioural treatment program for pathological gambling. The selection of controlled gambling by one-third (34%) of the sample suggests that, at least in the Australian context, controlled gambling is a relatively popular goal of treatment for female pathological gamblers. In this study, the only differences between treatment-seeking female pathological gamblers selecting abstinence and controlled gambling were that those selecting controlled gambling were older and were less likely to endorse the belief that problematic gambling is a disease or affliction that can only be overcome by lifelong abstinence. Further research investigating the characteristics of pathological gamblers associated with controlled gambling as both a goal and outcome of treatment is required in order to ensure that treatment-seeking pathological gamblers can make an informed decision regarding their goal selection.     

Examining DSM-IV Criteria for Pathological Gambling: Psychometric Properties and Evidence from Cognitive Biases

We examined the DSM-IV criteria for pathological gambling as assessed with the DSM-IV-based Diagnostic Interview for Gambling Severity (DIGS; Winters, Specker, & Stinchfield, 2002). We first analyzed the psychometric properties of the DIGS, and then assessed the extent to which performance on two judgment and decision-making tasks, the Georgia Gambling Task (Goodie, 2003) and the Iowa Gambling Task (Bechara, Damasio, Damasio, & Anderson, 1994), related to higher reports of gambling pathology. In a sample of frequent gamblers, we found strong psychometric support for the DSM-IV conception of pathological gambling as measured by the DIGS, predictive relationships between DIGS scores and all cognitive performance measures, and significant differences in performance measures between individuals with and without pathological gambling. Analyses using suggested revisions to the pathological gambling threshold (Stinchfield, 2003) revealed that individuals meeting four of the DSM-IV criteria aligned significantly more with pathological gamblers than with non-pathological gamblers, supporting the suggested change in the cutoff score from five to four symptoms. Discussion focuses on the validity of the DSM-IV criteria as assessed by the DIGS and the role of cognitive biases in pathological gambling.     

Full of Sound and Fury,Signifying Something: The Impact of Autonomic Arousal on EGM Gambling

An experiment was conducted to observe the influence of autonomic arousal on subsequent gambling behavior. Thirty-seven male and 32 female regular Electronic Gaming Machine (EGM) players were recruited through newspaper advertisements. Participants were randomly assigned to either: (1) a control condition, or (2) an experimental condition that introduced a loud white-noise event (80 db) at fixed 120 s intervals throughout the 5-min EGM gambling session. Galvanic Skin Response (GSR) measurements showed that the manipulation was successful in elevating autonomic arousal. The results showed differences in behavioral response to the manipulation based on prior experience with gambling problems. Persons with many gambling problems had lower average bet-sizes in the white-noise condition compared to the control, while those with few or no problems had higher average bet-sizes. The results suggest that arousal may provide different signals to gamblers with few versus many problems. Gamblers with many problems may interpret their arousal as a sign that they will soon lose money, while gamblers with few or no problems may associate feelings of arousal exclusively with winning.     

Problem Gambling and Intimate Partner Violence

This study examined the prevalence and severity of intimate partner violence (IPV) among 248 problem gamblers (43 women, 205 men) recruited from newspaper advertisements. The main outcome measures used were the Canadian Problem Gambling Index, the Conflicts Tactics Scale-2, the State Trait Anger Expression Inventory-2, the drug and alcohol section of the Addiction Severity Index and the substance use section of the Structured Clinical Interview for the DSM-IV. In this sample, 62.9% of participants reported perpetrating and/or being the victims of IPV in the past year, with 25.4% reporting perpetrating severe IPV. The majority of the sample (64.5%) also had clinically significant anger problems, which was associated with an increased risk of being both the perpetrator and victim of IPV. The presence of a lifetime substance use disorder among participants who had clinically significant anger problems further increased the likelihood of both IPV perpetration and victimization. These findings underscore the importance of routinely screening gambling clients for anger and IPV, and the need to develop public policy, prevention and treatment programs to address IPV among problem gamblers. Future research to examine IPV among problem gamblers is recommended.     

Pathological Gambling in Estonia: Relationships with Personality,Self-Esteem,Emotional States and Cognitive Ability

Due to changes in gambling accessibility during the last decade gambling has become more widespread in Estonia and the prevalence of pathological gambling has sharply increased. The present study attempts to identify psychological characteristics of Estonian pathological gamblers. It has been shown that a wide range of social, economic, and individual factors (e.g. personality traits and emotional states) predict the likelihood of becoming a pathological gambler. In the present study, pathological gamblers’ (N = 33) personality traits, self-esteem, self-reported emotional states and cognitive ability were compared to the respective characteristics in a non-gambling control group (N = 42) matched for age, gender and educational level. It was found that compared to controls, pathological gamblers had higher scores on Neuroticism (especially on its immoderation facet) and lower scores on Conscientiousness (especially on its dutifulness and cautiousness facets) and on self-esteem scale. They reported more negative emotional states during the previous month (especially depression and anxiety). Finally, pathological gamblers had lower general cognitive ability. In a logistic regression model, the likelihood of being a pathological gambler was best predicted by high immoderation score and low cognitive ability.

Measuring Self-efficacy in Gambling: The Gambling Refusal Self-Efficacy Questionnaire

This paper reports on the development and psychometric properties of a Gambling Refusal Self-Efficacy Questionnaire (GRSEQ). Two hundred and ninety-seven gamblers from both normal and clinical populations completed an initial set of 31-items of which 26 were selected for inclusion in the final version of the GRSEQ. A series of factor analyses showed four clear factors accounting for 84% of the variance. These factors can be summarised as situations and thoughts associated with gambling, the influence of drugs on gambling, positive emotions associated with gambling and negative emotions associated with gambling. The GRSEQ total score and factors scores showed high internal consistency (Cronbach’s alpha ranging from 0.92 to 0.98). Participants experiencing problems with gambling scored significantly lower on the GRSEQ, and discriminant analyses showed that the scale is able to correctly classify the non-problem (i.e., community and student samples) and problem gamblers (i.e., clinical sample). Furthermore, the GRSEQ showed significant negative relationships with other gambling-related variables (gambling urge and gambling-related cognitions) and negative mood states (depression, anxiety and stress) and was shown to be sensitive to change in treatment of pathological gambling. The results suggest that the GRSEQ is a useful measure of gambling refusal self-efficacy that is suitable for assessment of gamblers from both normal and clinical populations.     

Not the Same: A Comparison of Female and Male Clients Seeking Treatment from Problem Gambling Counselling Services

Previous studies of problem gamblers portray this group as being almost exclusively male. However, this study demonstrates that females comprised 46% of the population ( n = 1,520) of persons who sought assistance due to concerns about their gambling from the publicly-funded BreakEven counselling services in the state of Victoria, Australia, in one 12-month period. This suggests that the model of service delivery which is community based counselling on a non-residential basis may be better able to attract female clients than treatment centres where males predominate such as veterans centres. A comparative analysis of the social and demographic characteristics of female and male gamblers within the study population was undertaken. As with previous studies, we have found significant differences between males and females who have sought help for problems associated with their gambling. Gender differences revealed in this study include females being far more likely to use electronic gaming machines (91.1% vs. 61.4%), older (39.6 years vs. 36.1 years), more likely to be born in Australia (79.4% vs. 74.7%), to be married (42.8% vs. 30.2%), living with family (78.9% vs. 61.5%) and to have dependent children (48.4% vs. 35.7%), than males who present at these services. Female gamblers (A$7,342) reported average gambling debts of less than half of that owed by males (A$19,091). These gender differences have implications for the development and conduct of problem gambling counselling services as it cannot be assumed that models of service which have demonstrated effectiveness with males will be similarly effective with females.     

Missouri Casino Self-Excluders: Distributions Across Time and Space

According to public health research, exposure to casinos is a risk factor for disordered gambling. Consequently, casino self-exclusion programs, which provide gamblers with the opportunity to voluntarily seek limits on their access to gambling venues, can serve as a barometer of the concentration of disordered gambling in an area. This study reports on the distribution, both temporally and geographically, of 6,599 people who applied to exclude themselves from Missouri casinos between November, 1996 and February, 2004. Analyses used Microsoft MapPoint to plot the location of casinos and self-excluders (SEs) across Missouri and its constituent counties. These regional exposure analyses showed that the Western region around Kansas City is an epicenter of disordered gambling as, to a lesser extent, is the Eastern region around St. Louis. The annual number of SE enrollments increased during the first few years of the Missouri self-exclusion program and then leveled off during the later years. These findings have important implications for public health and the development of public health interventions for disordered gamblers.     

Significant Others and Gambling Treatment Outcomes

Aims This study investigates the effect of significant others on treatment outcomes among treated pathological gamblers. Design This is a cohort study of individuals who received gambling treatment. Setting Oregon Problem Gambling Services (OPGS) for gamblers and their family members. Participants 4,410 adult gamblers who were discharged from treatment between August, 2001 and April, 2007. Measurements OPGS enrollment forms provided gambler gender, age, ethnicity, education level, employment status, gambling-related debt, and whether the gambler had a significant other at the time of enrollment. Termination forms provided information on the type of discharge (successful/unsuccessful) and treatment length (in days). Participation of the gambler’s significant other in the family treatment program was identified. Findings Results showed that age, ethnicity, gambling debt, and having a significant other are associated with the odds of successful treatment. Education level moderates the effect of having a significant other on treatment success. Age, ethnicity, education, employment, and having a significant other participate in treatment significantly impacted gamblers’ length in treatment. Conclusions These findings indicate that there may be a benefit to integrating significant others in gambling treatment methods. Significant others may act as social supports for gamblers seeking treatment, and involving loved ones in gambling treatment models may positively affect gambler treatment outcomes.     

Risk Factors for Problematic Gambling: A Critical Literature Review

This article is a critical review of risk factors for pathological gambling categorized by demographics, physiological and biological factors, cognitive distortions, comorbidity and concurrent symptoms, and personality symptoms and characteristics. There is also a varia section (availability, parents playing, sensory characteristics, schedules of reinforcement, age of onset, and playing duration). The review found very few well established risk factors for pathological gambling (i.e. more than two studies to support the conclusions). Well established risk factors included demographic variables (age, gender), cognitive distortions (erroneous perceptions, illusion of control), sensory characteristics, schedules of reinforcement, comorbid disorders (OCD, drug abuse), and delinquency/illegal acts. An understanding of risk factors for pathological gambling should enhance prevention and treatment approaches.