Gambling-Related Harms Among Adolescents: A Population-Based Study

Internationally, and also in Europe, adolescent gambling is increasingly recognized as an important public health issue. Most research on adolescent gambling, however, is prevalence-focused and population-based studies are scarce. Few studies have examined gambling-related harms among adolescents. In a national sample, we examined self-experienced harms related to gambling and the relationship between reported harms and gambling behavior among Finnish adolescents. A national survey of 12–18-year-olds was conducted in Finland in 2011 (N = 4,566). Main measures were frequency of gambling and gambling-related harms reported during the past 6 months. The relationship between reported harms and gambling behavior was assessed using logistic regression analysis. Overall, 44% had gambled during the past 6 months. Of the sample, 12% were frequent gamblers (at least weekly) and 32% were occasional gamblers (monthly or less often). Compared to occasional gamblers, frequent gamblers were more likely to experience harms. The most commonly reported harms among frequent gamblers were “felt guilty or shameful due to gambling” (17%) followed by “problems with relationships” (13%) and “disruptions of daily rhythm” (10%). In age and gender-adjusted analysis, daily gamblers were significantly more likely to report all different types of harms when compared to other groups. These findings suggest that when planning and targeting youth gambling prevention and harm reduction strategies the nature and extent to which gambling may contribute to the different types of harms are important to consider.     

Excessive Gambling and Online Gambling Communities

The Internet provides an accessible context for online gambling and gambling-related online communities, such as discussion forums for gamblers. These communities may be particularly attractive to young gamblers who are active Internet users. The aim of this study was to examine the use of gambling-related online communities and their relevance to excessive gambling among 15–25-year-old Finnish Internet users (N?=?1200). Excessive gambling was assessed by using the South Oaks Gambling Screen. Respondents were asked in a survey about their use of various kinds of gambling-related online communities, and sociodemographic and behavioral factors were adjusted. The results of the study revealed that over half (54.33%) of respondents who had visited gambling-related online communities were either at-risk gamblers or probable pathological gamblers. Discussion in these communities was mainly based on sharing gambling tips and experiences, and very few respondents said that they related to gambling problems and recovery. In three different regression models, visiting gambling-related online communities was a significant predictor for excessive gambling (with 95% confidence level) even after adjusting confounding factors. The association of visiting such sites was even stronger among probable pathological gamblers than among at-risk gamblers. Health professionals working with young people should be aware of the role of online communities in terms of development and persistence of excessive gambling. Monitoring the use of online gambling communities as well as utilizing recovery-oriented support both offline and online would be important in preventing further problems. Gambling platforms should also include warnings about excessive gambling and provide links to helpful sources.     

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

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

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.     

Gambling Responsibly: Who Does It and To What End?

Numerous responsible gambling (RG) strategies are promoted to assist consumers to “gamble responsibly”. However, consumer adoption of RG strategies, how this varies by gambler risk group, and whether usage is associated with non-problematic gambling are largely unknown. This study aimed to (1) determine how use of RG-related strategies differs amongst regular gamblers by gambler risk group; and (2) identify RG-related strategies whose usage predicts non-problem/low risk gambling. Regular Australian gamblers on high-risk products (N = 860), recruited through gambling venues and an online wagering operator, were surveyed about their use of RG strategies promoted on the website of their jurisdiction’s main RG agency. Knowledge of RG strategies was reasonably high amongst all gambler risk groups, but lower-risk groups were more likely to use RG strategies. A logistic regression correctly predicted 82.1 % of lower-risk gamblers and 77.2 % of higher-risk gamblers. Predictors of lower-risk gambling included: greater confidence in their understanding of RG; endorsement of lower gambling expenditure and frequency limits; fewer erroneous gambling beliefs; being less likely to gamble to win money, challenge their skills/beat the odds, or forget about worries and stresses; and being more likely to gamble for pleasure/entertainment. Lower-risk gamblers were more likely to set a money limit in advance of gambling and to balance their gambling with other activities. These findings contribute to understanding which strategies are favoured by different risk groups, and which are associated with safer levels of gambling. They can guide consumer information aimed at enhancing RG consumption and future research on RG consumption.     

Problem Gambling Family Impacts: Development of the Problem Gambling Family Impact Scale

Although family members of problem gamblers frequently present to treatment services, problem gambling family impacts are under-researched. The most commonly endorsed items on a new measure of gambling-related family impacts [Problem Gambling Family Impact Measure (PG-FIM: Problem Gambler version)] by 212 treatment-seeking problem gamblers included trust (62.5 %), anger (61.8 %), depression or sadness (58.7 %), anxiety (57.7 %), distress due to gambling-related absences (56.1 %), reduced quality time (52.4 %), and communication breakdowns (52.4 %). The PG-FIM (Problem Gambler version) was comprised of three factors: (1) financial impacts, (2) increased responsibility impacts, and (3) psychosocial impacts with good psychometric properties. Younger, more impulsive, non-electronic gaming machine (EGM) gamblers who had more severe gambling problems reported more financial impacts; non-EGM gamblers with poorer general health reported more increased responsibility impacts; and more impulsive non-EGM gamblers with more psychological distress and higher gambling severity reported more psychosocial impacts. The findings have implications for the development of interventions for the family members of problem gamblers.     

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.     

Prevalence of Problem Gambling Among Adolescents: A Comparison Across Modes of Access,Gambling Activities,and Levels of Severity

The high availability and accessibility of online gambling have recently caused public concern regarding the potential increase of gambling-related problems among young people. Nonetheless, few studies among adults and none among adolescents have explored specific characteristics of gamblers as a function of gambling venues to date. This study sought to analyze the prevalence of gambling among a sample of adolescents in the last year, as well as sociodemographic and gambling-related characteristics as possible predictors of at-risk and problem gambling. The sample comprised 1313 adolescents aged 14–18 years. Participants were asked to respond to several questions regarding their gambling behavior. Chi square and ANOVA tests were performed in order to explore differences between groups, and a set of multinomial regressions established significant severity predictors. The prevalence of at-risk and problem gambling was 4 and 1.2 %, respectively. Regression analyses showed that having a relative with gambling problems predicted at-risk gambling. Both living with only one parent or not living with parents at all, and the prevalence of Electronic Gambling Machines in the last year were associated with problem gambling. Mixed-mode gambling was a predictor of both at-risk and problem gambling. Our findings extend previous research on gambling among adolescents by exploring gambling behavior according to different modes of access. Although the prevalence of exclusive online gambling among the total sample was low, these results support the need to consider specific subgroups of gamblers and their concrete related features when conducting both indicated prevention and treatment protocols for adolescents.     

Gender differences in gambling preferences and problem gambling: a network-level analysis

Most gambling studies have a gender-blind research approach, although a large body of scientific evidence suggests that gambling in females is on the rise and that males and females have different gambling behaviours and experience specific gambling-related harm. This study addressed these gender differences using a network analysis, an innovative approach considering disorders/concepts as dynamic systems of interacting symptoms/items. Data on gambling activities, problem gambling, substance use and mental health were collected in a representative sample of French adult gamblers (n = 8805). The study capitalized on the network analysis directly to compare associations of specific gambling activities with gambling disorder symptoms separately for both genders. The network analysis revealed that problem gambling was strongly associated with gambling machines among females, whereas it was related to sports betting, poker and casino games among males. The networks that included substance use and mental health showed that substance use was related to specific gambling activities. These findings confirm the links between various gender-specific gambling patterns and problem gambling and suggest a need to consider these gender differences to improve prevention efforts. More broadly, the present study further supports the importance of gender differences for gambling research and policy.     

Mapping the proportional distribution of gambling-related harms in a clinical and community sample

Excessive gambling results in a range of diverse harms experienced by individuals and their family members. However, little consideration has been given to specifically assessing such harms. Despite recent attempts to comprehensively ‘list’ and describe the ‘wide net’ of specific harms, what remains particularly unclear is the best way to measure the presence of harm and quantify its relationship to gambling. This article proposes a two-step method for quantifying gambling-related harm. From the literature, 104 questions assessing 48 items of harm were categorized into seven domains. Items were administered to 391 clinical and 151 community gamblers. Results suggest that while high-impact harms such as suicide and divorce are commonly associated with problem gambling, the reported frequency is low. Most gamblers sustain low-impact harms such as reduced savings and worry. This study presents the evaluation of specific gambling-related harms distributed in a clinical and community sample taking into account severity and its relationship to gambling behaviours. It is concluded that gambling-related harms negatively impact on quality of life with a minority suffering more severe harms. It is argued that the proposed two-step methodology provides a basis for developing a psychometrically valid measure of gambling-related harm.     

Determining optimal placement for pop-up messages: evaluation of a live trial of dynamic warning messages for electronic gaming machines

Dynamic warning messages are a harm minimization strategy aimed at preventing or reducing gambling-related problems by assisting individuals to make informed choices about their gambling. Laboratory studies have demonstrated the efficacy of dynamic warnings in facilitating responsible gambling. This article presents the results of a trial of the related effectiveness of dynamic warnings appearing either in the middle or on the periphery of electronic gaming machines (EGMs) screens in commercial gambling venues. Regular gamblers (n = 667) were surveyed to assess their recall of warning messages and the perceived impact of message placement on thoughts and behaviours. Messages appearing in the middle of screens were recalled to a greater extent, and respondents reported that these were more impactful and useful than messages on the periphery of screens. As one of the first trials of dynamic warning messages in operating EGM venues, the results provide important verification and validation of previous laboratory research. Results demonstrate that dynamic warning messages appearing in the middle of an EGM screen during play are likely to be a more effective harm minimization intervention than messages on the periphery of EGM screens.     

Effects of Gambling-Related Cues on the Activation of Implicit and Explicit Gambling Outcome Expectancies in Regular Gamblers

The current research examined whether the presentation of gambling-related cues facilitates the activation of gambling outcome expectancies using both reaction time (RT) and self-report modes of assessment. Gambling outcome expectancies were assessed by having regular casino or online gamblers (N = 58) complete an outcome expectancy RT task, as well as a self-report measure of gambling outcome expectancies, both before and after exposure to one of two randomly assigned cue conditions (i.e., casino or control video). Consistent with hypotheses, participants exposed to gambling-related cues (i.e., casino cue video condition) responded faster to positive outcome expectancy words preceded by gambling prime relative to non-gambling prime pictures on the post-cue RT task. Similarly, participants in the casino cue video condition self-reported significantly stronger positive gambling outcome expectancies than those in the control cue video condition following cue exposure. Activation of negative gambling outcome expectancies was not observed on either the RT task or self-report measure. The results indicate that exposure to gambling cues activates both implicit and explicit positive gambling outcome expectancies among regular gamblers.     

Gambling Participation,Expenditure and Risk of Harm in Australia, 1997–1998 and 2010–2011

Gambling-related harm results primarily from financial losses. Internationally Australia continues to rank as the largest spending nation per capita on gambling products. This would suggest that Australian gamblers are at disproportionately high risk of harm despite almost two decades of industry scrutiny and regulation, and investment in research, treatment and education programs. However, declines in participation rates, per capita expenditure, household expenditure, national disposable income spent on gambling and problem gambling rates have been cited as evidence that fewer people are gambling, that gamblers are spending less, and that gambling safety in Australia has improved. The current study investigated these propositions using national population and accounts data, and statistics from Australia’s two population-representative gambling surveys conducted in 1997–1998 and 2010–2011. Despite a falling participation rate the study found no real change in the number of people gambling overall, and increasing numbers consuming casino table games, race wagering and sports betting. Further found were increases rather than decreases in average gambler expenditure, overall, and across most products, particularly electronic gaming machines (EGMs). Potentially risky levels of average expenditure were observed in both periods, overall and for race wagering, casino table gaming, and EGMs. Changes in the proportion of income spent on gambling suggest risks declined overall and for race wagering and casino table gaming, but increased for EGMs. Finally, while problem gambling statistics were not comparable between periods, the study found double the number of moderate risk gamblers previously estimated for 2010–2011 amongst the 2 million Australians found to have experienced one or more gambling-related problems. The findings have implications for public health policy and resourcing, and the way in which prevalence and expenditure statistics have been interpreted by researchers, government and industry in Australia and elsewhere.     

Gambling Harms and Gambling Help-Seeking Amongst Indigenous Australians

This paper aimed to analyze the harms arising from gambling and gambling-related help-seeking behaviour within a large sample of Indigenous Australians. A self-selected sample of 1,259 Indigenous Australian adults completed a gambling survey at three Indigenous sports and cultural events, in several communities and online. Based on responses to the problem gambling severity index (PGSI), the proportions of the sample in the moderate risk and problem gambler groups were higher than those for the population of New South Wales. Many in our sample appeared to face higher risks with their gambling and experience severe gambling harms. From PGSI responses, notable harms include financial difficulties and feelings of guilt and regret about gambling. Further harms, including personal, relationship, family, community, legal and housing impacts, were shown to be significantly higher for problem gamblers than for the other PGSI groups. Most problem gamblers relied on family, extended family and friends for financial help or went without due to gambling losses. Nearly half the sample did not think they had a problem with gambling but the results show that the majority (57.7 %) faced some risk with their gambling. Of those who sought gambling help, family, extended family, friends and respected community members were consulted, demonstrating the reciprocal obligations underpinning traditional Aboriginal culture. The strength of this finding is that these people are potentially the greatest source of gambling help, but need knowledge and resources to provide that help effectively. Local Aboriginal services were preferred as the main sources of professional help for gambling-related problems.     

Cognitive distortions as a problem gambling risk factor in Internet gambling

The purpose of this study was to examine the role of cognitive distortions in Internet gambling. The primary objectives were to determine whether cognitive distortions predict Internet gambling and investigate whether distorted gambling-related cognitions are associated with problem gambling severity among online gamblers. Three hundred and seventy four undergraduate participants (143 online gamblers, 172 males) completed an online questionnaire looking at demographics, play-related variables (duration, frequency and expenditures of play) and cognitive distortions. Variables were entered into a logistic regression model to predict online gambling. Three variables made independent contributions to predicting Internet gambling: male gender, higher frequency of play, and cognitive distortions. A hierarchical linear regression analysis with Internet gamblers revealed that cognitive distortions accounted for a proportion of the variance in problem gambling severity beyond variance accounted for by demographic variables and level of gambling involvement. Results suggest that cognitive distortions are a risk factor in online gambling.     

The Social and Psychological Impacts of Gambling in the Cree Communities of Northern Québec

A detailed survey of gambling, addiction and mental health was conducted with randomly selected respondents (n = 506) from four Cree communities of Northern Quebec. The study examined the current patterns of gambling in relation to demographic, social, and psychological factors. Instruments included the Canadian Problem Gambling Index, Addiction Severity Index, Beck Depression Inventory and the computerized Diagnostic Interview Schedule for psychiatric diagnoses. Overall, 69.2 % of the total sample participated in any gambling/gaming activities over the past year; 20.6 % of this group were classified as moderate/high risk gamblers, and 3.2 % were classified in the highest “problem gambling” category. Considering the entire sample, the overall prevalence of problem gambling was 2.2 %. Women were significantly more likely to play bingo (56.6 %) compared to men (35.1 %) and they played more frequently; 20.8 % of women versus 3.8 % of men played once/week or more often. Compared to the no/low risk gamblers, a greater proportion of moderate/high risk gamblers were cigarette smokers (44.8 vs. 56.3 %), they were more likely to meet DSM-IV diagnostic criteria for alcohol dependence (21.2 vs. 46.2 %), and they were more likely to report moderate to severe depressive symptoms in the past month. Risk factors for problem gambling included traumatic life events (physical and emotional abuse), anxiety and depression, as well as drug/alcohol abuse. The high rates of comorbidity between problem gambling, tobacco dependence, substance abuse and other psychological problems demonstrate that gambling among some Cree adults is part of a pattern of high-risk factors for negative long-term health consequences. The results also have implications for treatment, suggesting that interventions for gambling disorders should not focus on gambling alone but rather the constellation of high-risk behaviours that pose a risk to recovery and well-being.     

An Empirical Study of Gender Differences in Online Gambling

Gambling has typically been considered a predominately male activity. However, recent prevalence surveys have shown greater numbers of females are now gambling. Much of the gambling literature suggests online gamblers are more likely to be male, and that problem gamblers are more likely to be male. Males and females are also likely to be gambling for different reasons and have a preference for different gambling activities. Little is known about the pattern of play among female online gamblers. The aim of this survey was to develop a better profile of female online gamblers and to examine any gender differences between males and females in terms of how and why they gamble online, their frequency of online gambling, patterns of play, as well as attitudes to online gambling. The survey was posted on 32 international online gambling websites and was completed by 975 online gamblers (including 175 female online gamblers). Chi-square tests of association were conducted to examine the association between gender and a range of variables. The results showed that females had been gambling online for a shorter duration of time than males, had much shorter online gambling sessions, different motivations for gambling online (i.e., to practice for free, to spend less money and out of boredom), and experienced online gambling differently to males, with increased feelings of guilt and shame for gambling online. This suggests there is still a stigma around gambling particularly evident among females in this study. The findings indicate that clinicians and treatment providers need to be aware of these potential gender differences in online gambling to develop appropriately tailored interventions.     

Gender Differences in the Presentation of Observable Risk Indicators of Problem Gambling

In many countries where gambling is legalised, there has been a strong public policy focus on the need for strategies to reduce gambling related harm. These have often included policies requiring staff in gambling venues to identify and/or assist people who might be experiencing gambling-related harm. To facilitate this process, researchers have developed visible behavioural indicators that might be used to profile potentially problematic gambling. Few of these studies have, however, examined whether such indicators or ‘warning signs’ might differ between men and women. In this study, we describe the results of an analysis of data drawn from 1185 fortnightly gamblers that included 338 problem gamblers as classified by the Problem Gambling Severity Index. Indicators of problem gambling were similar between males and females with a few key exceptions. Indicators reflecting emotional distress were more commonly reported by females with gambling problems, whereas problem gambling males were more likely to display aggressive behaviour towards gambling devices and others in the venue. Amongst males, signs of emotional distress as well as attempts to conceal their presence in venues from others most strongly differentiated between problem and non-problem gamblers. Amongst females, signs of anger, a decline in grooming and those attempts to access credit were the most distinguishing indicators. These findings have implications for the refinement of identification policies and practices.     

Gender Differences in Characteristics of Chinese Treatment-Seeking Problem Gamblers

A total of 952 (841 men and 111 women) Chinese treatment-seeking problem gamblers completed self-report assessment forms. Female in contrast to male gamblers were more likely to be older, married, less educated, and without employment. Female gamblers also started gambling at an older age, had a shorter gambling history, preferred casino and mahjong gambling, and reported more somatic complaints and suicidal thoughts. Male and female gamblers accumulated similar amount of gambling debt and reported an average of 12 gambling-related problems on the Chinese version of the South Oaks Gambling Screen [Lesieur and Blume (Am J Psychiatry 144:1184–1188, 1987)]. Both groups were similarly troubled by their indebtedness, inability to control gambling, and gambling-related interpersonal problems. However, female gamblers had fewer means to pay their gambling debt. Given that significant gender-related differences were observed in Chinese problem gamblers, prevention and treatment services should attend to specific needs of male and female gamblers.     

The relationship between explicit and implicit learning processes and probable pathological gambling

This paper reports the findings of a study of explicit and implicit learning and gambling with non-problem (n = 107), sub-clinical problem gamblers (n = 13), and probable pathological gamblers (n = 46). Two probability learning tasks modeled after gambling games and an artificial grammar task were used to explore how people learn patterns. In each of the two probability learning tasks, the outcome of the game was biased during the first part (learning phase) of the task. The results showed that many of the participants in the experimental conditions learned the bias and gradually unlearned the bias during the extinction phase of the study. Probable pathological gamblers showed less retention of the bias during two probability tasks and repeated the same errors during the artificial grammar task suggesting that they emphasize explicit learning strategies rather than implicit learning strategies. The results are consistent with the idea that pathological gamblers are more likely to utilize explicit rules than implicit rules.