Twelve-Month Prevalence of DSM-5 Gambling Disorder and Associated Gambling Behaviors Among Those Receiving Methadone Maintenance

This study sought to: (1) determine the prevalence of gambling disorder using the Diagnostic and Statistical Manual of Mental Disorders Version 5 (DSM-5; American Psychiatric Association in Diagnostic and statistical manual of mental disorders, American Psychiatric Publishing, Arlington, 2013) criteria; (2) identify the frequency and amount of money spent on gambling behaviors; and (3) determine demographic and treatment related predictors associated with gambling disorder in a substance using population. People receiving methadone maintenance treatment (N = 185) in an urban medical center consented to participate in the study. We used DSM-5 criteria to assess the 12-month prevalence of gambling disorder. Questions adapted from a previously developed measure were used to identify, describe and quantify the frequency of use and amount of money spent on gambling behaviors. Most participants were African-American (71.4 %), male (54.1 %), unmarried (76.8 %), unemployed (88.1 %) and had an income of <$20,000 (88.5 %). On average, participants were receiving 81.0 mg of methadone (SD: 22.8) daily. Nearly half (46.2 %) of participants met DSM-5 criteria for gambling disorder. Compared to those without gambling disorder, those with gambling disorder did not differ significantly with respect to demographic characteristics nor methadone dose. However, those with gambling disorder had been in methadone maintenance treatment for significantly less time. Those with gambling disorder were significantly more likely to report engaging in a variety of gambling behaviors. Given that the 12-month prevalence of DSM-5 defined gambling disorder was nearly 50 % future efforts to screen and treat gambling disorder in the context of methadone maintenance treatment are clearly warranted.     

The Relationship of Problem Gambling to Criminal Behavior in a Sample of Canadian Male Federal Offenders

This article examines the prevalence of moderate and severe problem gambling in a sample of 254 incarcerated Canadian male federal offenders (completion rate of 39.0%). The prevalence of disordered gambling was measured using the PGSI, DSM-IV-TR, and SOGS that yielded estimates of 9.4%, 6.3%, and 13.0%, respectively. Severe problem gamblers were significantly more likely to have committed income producing offences, but were neither more nor less likely than other offenders to have committed violent offences. The majority of severe problem gamblers (65.2%) and a fifth of the moderate problem gamblers (20.0%) reported that their criminal activity was a result of their gambling (e.g., to pay off debts). Based on these findings there appears to be a need to offer problem gambling treatment services to offenders in order to help them break the cycle of gambling, debt and crime.     

Criminal Behavior Associated with Pathological Gambling

The influence of addictive gambling behavior on criminal behavior was examined in this study. A sample of pathological gamblers from in- and outpatient treatment centers and self-help groups (n = 300) and a sample of high and low frequency gamblers from the general population and army (n = 274) completed a comprehensive questionnaire which assessed social attachment, personality, pathological gambling and criminal behavior variables. The causal analysis of a Lisrel Model leads to the following results: addictive gambling behavior is an important criminogenic factor. This predisposing factor alone cannot sufficiently explain criminal behavior associated with pathological gambling. Personality variables also directly influence the intensity of criminal behavior. Social attachment variables have only an indirect effect. As far as property offenses are concerned, it was found that the direct causal effect of addiction behavior is greater than that of personality.     

Reliability,Validity, and Classification Accuracy of the DSM-5 Diagnostic Criteria for Gambling Disorder and Comparison to DSM-IV

The DSM-5 was published in 2013 and it included two substantive revisions for gambling disorder (GD). These changes are the reduction in the threshold from five to four criteria and elimination of the illegal activities criterion. The purpose of this study was to twofold. First, to assess the reliability, validity and classification accuracy of the DSM-5 diagnostic criteria for GD. Second, to compare the DSM-5–DSM-IV on reliability, validity, and classification accuracy, including an examination of the effect of the elimination of the illegal acts criterion on diagnostic accuracy. To compare DSM-5 and DSM-IV, eight datasets from three different countries (Canada, USA, and Spain; total N = 3247) were used. All datasets were based on similar research methods. Participants were recruited from outpatient gambling treatment services to represent the group with a GD and from the community to represent the group without a GD. All participants were administered a standardized measure of diagnostic criteria. The DSM-5 yielded satisfactory reliability, validity and classification accuracy. In comparing the DSM-5 to the DSM-IV, most comparisons of reliability, validity and classification accuracy showed more similarities than differences. There was evidence of modest improvements in classification accuracy for DSM-5 over DSM-IV, particularly in reduction of false negative errors. This reduction in false negative errors was largely a function of lowering the cut score from five to four and this revision is an improvement over DSM-IV. From a statistical standpoint, eliminating the illegal acts criterion did not make a significant impact on diagnostic accuracy. From a clinical standpoint, illegal acts can still be addressed in the context of the DSM-5 criterion of lying to others.     

An Overview of and Rationale for Changes Proposed for Pathological Gambling in DSM-5

The fifth revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is scheduled for publication in 2013. It will include several changes to the diagnosis of pathological gambling: the name of the disorder will be altered, the threshold for diagnosis will decrease, and one criterion will be removed. This paper reviews the rationale for these changes and addresses how they may impact diagnosis and treatment of the disorder, as well as potential for future research in the field.     

Narcissistic Implications in Gambling Disorder: The Mediating Role of Emotion Dysregulation

Gambling Disorder (GD) is a complex psychopathology involving a numbers of cognitive, behavioral, emotional and neurobiological determinants. Previous research suggests that GD may frequently co-occur with Narcissistic Personality Disorder. However, there is still a lack of study investigating Pathological Narcissism (PN) in both its vulnerable and grandiose facets among clinical population. Moreover, emotional dysregulation is commonly thought to underlie GD albeit research on this topic remains poor. The present study aims to investigate the role of both vulnerable and grandiose narcissism in relation to GD as well as the mediator role played by emotion dysregulation in such link. We administered to a sample of addicted gamblers (n = 74) and a sample of heathy controls (n = 105), the South Oaks Gambling Screen (SOGS), the Pathological Narcissism Inventory (PNI) and the Difficulties in Emotion Regulation Scale (DERS). Differences across groups emerged on the scores obtained on the PNI and DERS. Moreover, we found positive associations between SOGS scores and both PNI and DERS. Also, strategic addicted gamblers showed higher levels of vulnerable narcissism compared to others. Finally, emotion dysregulation difficulties appeared to fully mediate the relationship between grandiose narcissism and GD severity. Grandiose and vulnerable narcissism appear important variables involved in GD. Also, emotion regulation deficits seem to account for GD and to explain the pathways by which grandiose narcissism leads to GD. Clinical implications and future directions are discussed.     

College Women Eating Disorder Diagnostic Profile and DSM-5

Abstract

A consistent diagnostic profile describing college women with eating disorders has been well established in the college health and mental health literature. This diagnostic framework traditionally has been associated with the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision¹ Eating Disorders Not Otherwise Specified category. In this article, the authors discuss implications of the recently revised Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition² eating disorder diagnostic categories for the existing college women eating disorder profile.     

Gambling Disorder in Veterans: A Review of the Literature and Implications for Future Research

To review the scientific literature examining gambling behavior in military veterans in order to summarize factors associated with gambling behavior in this population. Database searches were employed to identify articles specifically examining gambling behavior in military veterans. Cumulative search results identified 52 articles (1983–2017) examining gambling behavior in veteran populations. Articles generally fell into one or more of the following categories: prevalence, psychological profiles and psychiatric comorbidities, treatment evaluations, measurement, and genetic contributions to gambling disorder. Results from reviewed articles are presented and implications for future research discussed. Research to date has provided an excellent foundation to inform potential screening, intervention and research activities going forward. The authors suggest that a public health approach to future research endeavors would strengthen the evidence base regarding gambling in veteran populations and better inform strategies for screening, prevention and treatment.     

Gambling Behavior Among Adolescents with Attention Deficit/Hyperactivity Disorder

Impulsivity is inherent to both problem gambling and ADHD. The purpose of this study is to examine ADHD key symptoms, and gambling behaviors and problem severity among adolescents. Additionally, internalizing and externalizing behaviors exhibited among these individuals and the role of these symptoms in gambling are examined. We used a cross-sectional study design and survey 1,130 adolescents aged 12–19. Results indicated that adolescents who screened positive for ADHD were significantly more likely than non-ADHD adolescents to engage in gambling and significantly more likely to develop gambling problems. Those who screened positive as predominantly inattentive and those who screened positive for ADHD Combined (Inattention and Hyperactivity–Impulsivity) were equally likely to gamble, but the latter were twice as likely to have gambling problems. However, we found no significant interaction between the key ADHD symptoms and gambling as the severity of hyperactivity–impulsivity or inattention did not significantly differ with respect to gambling pathology. Emotional problems and depressive affect were the only variables that could significantly differentiate the ADHD types and gambling severity. Our Results highlight the clinical importance of considering the subtype of ADHD among gamblers and the greater association of depressive affect and emotional problems with gambling among adolescents.     

Profiling Lady Luck: An Empirical Study of Gambling and Problem Gambling Amongst Female Club Members

This paper helps to address a deficiency of gender-specific research into gambling. It focuses on gambling participation, gaming machine play, and problem gambling amongst 1,257 female respondents to a telephone survey of 3,000 members selected randomly from the membership lists of six of the largest clubs in Sydney, Australia. Using predominantly non-parametric tests, results identify a range of behaviors that characterize the gambling activities of female club members when compared to their male counterparts. Testing four hypotheses revealed that, when compared to male club members, the females had a higher preference for bingo, lotto, lotteries, pools, and gaming machines; they gambled less frequently on off-course and on-course betting, casino table games and hotel gaming machines, but more frequently on bingo; they were more likely to display patterns of gaming machine play that maximize playing time; and they experienced problem gambling at levels comparable to males. Further research questions arising from the study's findings are discussed.     

The Convergence of Gambling and Digital Media: Implications for Gambling in Young People

Adolescents’ use of the Internet and other digital media for the purpose of gambling represents a serious concern in modern society. This paper overviews some of the available monetary and non-monetary forms of gambling within new digital and online media and monetary forms of games with gambling-like experiences. With reference to current psychological knowledge on the risk factors that promote adolescent gambling, it is suggested that new gambling technologies may: (a) make gambling more accessible and attractive to young people, (b) may promote factually incorrect information about gambling, (c) provide an easy escape from real world problems such as depression and social isolation, (d) create a gambling environment that easily facilitates peer pressures to gamble, (e) ease parental transmission of gambling attitudes and beliefs, and (f) make gambling more ubiquitous and socially acceptable. The unique risks of Internet gambling for young people are critically discussed, as well as the lack of restricted classification for video games and other media that feature interactive, non-monetary forms of gambling.     

Lottery Playing Amongst Youth: Implications for Prevention and Social Policy

Factors associated with lottery ticket purchases, accessibility of lottery products, and lottery playing behaviour amongst 1,072 youth (ages 10-18 years old, mean age 14 years-old) was examined. Playing the lottery was found to be the most popular gambling activity with youth reporting playing all forms of lottery tickets including draws, scratch tickets, and sports lottery tickets. Youth reported beginning to play the lottery at age 12, with scratch ticket participation being amongst the most highly reported type of lottery activity with the youngest age of onset. The vast majority of youth are aware of the legal age to purchase tickets although many believed that there should be no age requirement to purchase any form of lottery ticket. Youth, regardless of their age, reported few if any difficulties in purchasing lottery tickets. Moreover, a third of underage youth reported going to the store specifically to purchase lottery tickets with this behaviour increasing with the age of the participant. This research confirms previous findings that lottery tickets are highly accessible to underage youth despite legal prohibitions. The results provide valuable information that can be subsequently used in the development of responsible social policy and youth gambling prevention programs     

Demographic,Behavioural and Normative Risk Factors for Gambling Problems Amongst Sports Bettors

Sports betting is growing exponentially, is heavily marketed and successfully targets young adult males. Associated gambling problems are increasing. Therefore, understanding risk factors for problem gambling amongst sports bettors is an increasingly important area of research to inform the appropriate design and targeting of public health and treatment interventions. This study aimed to identify demographic, behavioural and normative risk factors for gambling problems amongst sports bettors. An online survey of 639 Australian sports bettors using online, telephone and retail betting channels was conducted. Results indicated that vulnerable sports bettors for higher risk gambling are those who are young, male, single, educated, and employed full-time or a full-time student. Risk of problem gambling was also found to increase with greater frequency and expenditure on sports betting, greater diversity of gambling involvement, and with more impulsive responses to betting opportunities, including in-play live action betting. Normative influences from media advertising and from significant others were also associated with greater problem gambling risk. The results of this study can inform a suite of intervention, protection and treatment initiatives targeted especially at young male adults and adolescents that can help to limit the harm from this gambling form.     

Gambling Risk Amongst Adolescents: Evidence from a School-Based Survey in the Malaysian Setting

There has been emerging evidence regarding gambling experiences of young people in Asia recently, but to date, none in Malaysia. This study aimed to estimate the prevalence of gambling, and to identify individual, familial and high-risk behaviours factors among Malaysian adolescents. A cross-sectional study was conducted over 4 months at randomly selected secondary schools in Seremban in Negeri Sembilan state. A total of 2265 self-administered, anonymous questionnaires were distributed to the students. The students completed the questionnaire consisting of sociodemographic and family background, gambling behaviours, high risk behaviours and mental health questions. Approximately 29.6 % (95 % CI 27.7–31.5) of respondents reported participating in some forms of gambling activities in the previous 12 months. Among these, 3.6 % (95 % CI 2.8–4.3) of them were problem gamblers. Parental gambling was the strongest correlate with adolescent gambling behaviour. Signification association was found between gambling behaviour and gender (being males), but interestingly, not with ethnicity. Adolescents who reported engaging in high risk behaviours (such as smoking, alcohol consumption, involvement in physical fights, illegal vehicular racing) were also more likely to gamble. Gambling is not an uncommon phenomenon amongst Malaysian adolescents. Public awareness campaign, health education to targeted groups, revision of existing laws, and screening at primary care level should be implemented to address the issue of gambling among adolescents. This study also highlights the need to examine the national scope of the problem in Malaysia.     

Obstacles to Help-Seeking for Sexual Offenders: Implications for Prevention of Sexual Abuse

ABSTRACT

Persons with potentially harmful sexual interests such as attraction to minors are unlikely to seek or receive treatment before a sexual offense has been committed. The current study explored barriers to help-seeking in a sample of 372 individuals in treatment for sexual offending. Results revealed that the shame and secrecy resulting from stigma associated with pedophilic interests often prevented our respondents from seeking professional counseling, and only about 20% tried to talk to anyone about their sexual interests prior to their arrest. Barriers to seeking and receiving psychological services included concerns about confidentiality, fears of social and legal consequences, personal shame or confusion about the problem, affordability, and challenges finding competent therapists who were adequately equipped to help them. Understanding and ultimately reducing obstacles to help-seeking can improve the quality of life for people with harmful sexual interests and potentially prevent sexual abuse of children or other vulnerable individuals.