Risk Factors for Problem Gambling in California: Demographics,Comorbidities and Gambling Participation

While population surveys have been carried out in numerous jurisdictions internationally, little has been done to assess the relative strength of different risk factors that may contribute to the development of problem gambling. This is an important preparatory step for future research on the etiology of problem gambling. Using data from the 2006 California Problem Gambling Prevalence Survey, a telephone survey of adult California residents that used the NODS to assess respondents for gambling problems, binary logistic regression analysis was used to identify demographic characteristics, health-related behaviors, and gambling participation variables that statistically predicted the odds of being a problem or pathological gambler. In a separate approach, linear regression analysis was used to assess the impact of changes in these variables on the severity of the disorder. In both of the final models, the greatest statistical predictor of problem gambling status was past year Internet gambling. Furthermore, the unique finding of a significant interaction between physical or mental disability, Internet gambling, and problem gambling highlights the importance of exploring the interactions between different forms of gambling, the experience of mental and physical health issues, and the development of problem gambling using a longitudinal lens.     

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 epidemiology of pathological gambling: Critique of existing research and alternative strategies

As legalized gambling opportunities increase, the performance of research on pathological gambling assumes greater importance. In this regard, a useful starting point involves documenting the epidemiological nature of pathological gambling. Unfortunately, the only systematic study of the incidence/prevalence of pathological gambling which has yielded widely publicized and frequently cited results appears to possess several methodological problems. Thus, this paper critiques this study and discusses methodological issues relevant to any epidemiological research effort. In addition to sampling and measurement concerns, issues such as data accessibility, denial and related reactive effects, ethical considerations, and the appropriateness of various data collection methods are discussed to promote the conduct of sound pathological gambling research.     

Clinical and behavioral evaluation of pathological gambling in Barcelona,Spain

This paper assesses both the clinical characteristics and gambling behavior of 45 pathological gamblers (40 male, 5 female, average age 41) in a psychiatric hospital in Barcelona, Spain. These pathological gamblers tend to have other addictions and psychiatric disorders in addition to their pathological gambling. Suicidal ideation and attempts were one of the most frequent complications with these patients. Slot and fruit machines were found to be the most preferred form of gambling. Loans and crime were frequently used by the gambler to finance his or her gambling. Nevertheless, the gambler is rarely aggessive, and legal problems resulting from serious crimes are the exception. The profile presentes is similar to that found among pathological gamblers in other countries.     

Psychopathology and pathological gambling among males: Theoretical and clinical concerns

In this paper, some possible relationships between psychopathology and pathological gambling are delineated. The assessment and stabilization of such patients, including psychotherapeutic and pharmacologic strategies, are discussed. Guidelines for treating patients manifesting both a psychiatric illness and a gambling problem are suggested.     

Comparing the New Zealand and Swedish National Surveys of Gambling and Problem Gambling

National surveys of gambling and problem gambling have recently been completed in New Zealand and Sweden. These studies are unique in that data collection was undertaken by official government statistical agencies, involved large, nationally representative samples, and attained high response rates. Comparison of the findings is facilitated by the use of similar procedures and instrumentation and is of interest in that both countries have similar per capita gambling expenditure and welfare states that have recently undergone major economic and social restructuring. Data on gambling participation, problem gambling prevalence and risk factors for problem gambling are presented and discussed. While there are a number of similarities and differences, the Swedish findings are more similar to those of an earlier national survey conducted in New Zealand during 1991. This suggests that risk factors are changing over time in relation to evolving patterns of gambling participation and attitudes towards gambling, a finding that has implications for future patterns of gambling and problem gambling in these and other countries.     

Treatment issues pertaining to pathological gamblers with a comorbid disorder

Evidence of an increased risk for various psychiatric disorders among pathological gamblers far exceeds our understanding of the impact that this psychiatric comorbidity has on the outcome of treatment for pathological gambling. One major source of the problem is that treatment efficacy and effectiveness studies for pathological gambling typically have not addressed comorbidity's impact on outcome. This paper discusses epidemiological, clinical, health service delivery, and research issues pertaining to the intersection of pathological gambling treatment outcome and comorbid psychiatric disorders. It is argued that this topic suffers from major knowledge gaps in terms of the nature of comorbidity of pathological gambling and other psychiatric disorders and the role of client characteristics on treatment outcome for pathological gambling. Research priorities are identified.     

Does your older adult client have a gambling problem?

Pathological gambling is becoming an increasing problem in today's culture, particularly because opportunities and inducements to gamble abound. This article describes symptoms, consequences, and comorbidities experienced by pathological gamblers. Gambling pathology is often invisible because pathological gamblers seldom disclose gambling problems to their primary care provider. Thus, nurses will benefit from knowledge of the physical and emotional signs of the disorder. A two-question assessment tool, the Lie/Bet Questionnaire, is useful in helping nurses identify pathological gamblers. Interventions and treatment options, including group therapy and environmental modification, are also discussed. As always, education concerning problems and consequences of pathological gambling is a first step. Because research has indicated that visits to casinos by older adults have doubled since 1975, the authors use an example of an older adult to clarify the issues. Although the article's content is applicable to clients across the life span, it has particular significance for older adults.     

Perceived family history of problem gambling and scores on SOGS

A sample of 93 veterans (92.4% males), with a median age of 41, (Mean=43.5) attending clinics for problem drinking, drug abuse and other mental disorders was screened for problems associated with the diagnosis of pathological gambling. The diagnostic instrument employed was the South Oaks Gambling Screen developed by Lesieur and Blume. The data replicate earlier findings indicating a link between parental problem gambling and pathological gambling. The results extended this association to include grandparents thus firming the familial relationship. Several epidemiological measures were defined and illustrated. These included relative risk, the odds ratio, attributable risk percent and population attributable risk percent. The data were consistent with previous research that substance abusers are about six times as likely to be addicted to gambling as the general population.This research was supported in part by a grant from the Massachusetts Department of Public Health.     

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.     

Experimental Analysis of the Game in Pathological Gamblers: Effect of the Immediacy of the Reward in Slot Machines

Slot machines are the most “addictive” games because (a) the disorder (pathological gambling) appears more rapidly in these games than with any other; (b) most patients who seek professional help are mainly addicted to electronic gambling, and (c) even though it is not the more frequent game, most of all the money spent on legal games of chance (at least in Spain) goes to slot machines. Structural characteristics of slot machines induce to gamble because electronic games show the main parameters of operant conditioning, mainly the immediacy of the reinforcement. Ten pathological gamblers played slot machine in two conditions: immediate and delayed reinforcement. The results corroborate the importance of the immediacy of the reinforcement in gambling, because when the result appears immediately (after 2 s), more games are played than when the result is delayed only 10 s. Critical issues in problem gambling prevention and public health are discussed.     

DSM-IV-J Criteria: A Scoring Error That May Be Modifying the Estimates of Pathological Gambling Among Youths

Previous studies have shown that prevalence rates among youths may be inflated due to a problem in understanding the questions of the SOGS-RA and DSM-IV-MR-J. This article reports another reason why prevalence rates of pathological gambling among youths may be inflated. In 1992, Fisher proposed 9 criteria (the DSM-IV-J) for diagnosing pathological gambling among youths, and formulated 12 questions (the Test questions) to identify the presence of these criteria. An analysis of a sample of studies using the DSM-IV-J reveals that some researchers have incorrectly used the 12 Test questions instead of the 9 criteria, which may have led to overestimated prevalence rates among youths. Other measurement issues may also be contributing to the overestimation of problem gambling in young people. The methodological implications of these issues are discussed.     

Gambling and Problem Gambling in Sweden: Changes Between 1998 and 2009

Gambling participation and rates of problem gambling change over time in response to a variety of factors including gambling availability, demographic changes and adaptation at individual and societal levels. These relationship are complex and only partially understood. The major aim of the present study was to provide general population estimates of gambling participation and problem gambling for Sweden and compare these estimates with estimates from a previous national study. The study was also designed to identify risk factors for problem gambling including change in these factors over time. Data are from the first phase of the Swedish Longitudinal Gambling Study (Swelogs) in which a representative sample of 8,165 people was assessed using validated problem gambling and other measures to facilitate comparison with findings from the 1997/1998 Swedish Gambling Study (Swegs). Overall, it was found that gambling participation reduced markedly, although in some population sectors increases were evident for some forms including poker and electronic gaming machines. Lifetime prevalence of probable pathological gambling increased; however, past 12 months probable pathological and problem gambling prevalence did not. Males, younger adults and people born outside Sweden were at high risk in both studies. Significant prevalence increases were evident for people aged 18–24 and those with low levels of education. The results indicate that relationships between gambling exposure, participation and problems are dynamic with shifting implications for public health and social policy.     

GPs and Problem Gambling: Can they Help with Identification and Early Intervention?

General Practitioners (GPs) are well placed to identify problem gamblers and provide early intervention. To date there is no evidence to suggest that GP’s are routinely screening patients for potential gambling problems. This paper discusses the prevalence of problem gambling, the links with other health problems and ways that GPs can assist. Results from a pilot project that provided educational resources to GPS are also discussed. Suitable screening tools are available that could easily be used by GPs to assess the possibility of gambling problems in patients who may be at increased risk but do not seek help. Early identification and intervention may help prevent a gambling habit escalating to a serious problem. More work needs to be done to increase awareness with GPs of the extent of problem gambling in our community and to alert patients to the fact that gambling can affect their health and that GPs can help.     

Gambling in Western and Eastern Europe: The Example of Hungary

The history of gambling in post-socialist countries is noticeably different from that of other countries in Europe. The goal of this study was therefore twofold: Firstly, to systematically review all European epidemiological studies related to excessive gambling in the general adult population, and secondly, to provide an overview of the state of gambling in Hungary based on the first ever nationwide representative survey, setting the results against the backdrop of the earlier European studies. A systematic review was carried out of European gambling studies which focus on a representative adult general population. Hungarian data was obtained from the National Survey on Addiction Problems in Hungary general adult population survey (N = 2,710). Pathological gambling was measured by the South Oaks Gambling Screen. Lifetime prevalence of excessive gambling (problem and pathological gambling) in the general adult population of European countries varies between 1.1% (Italy and Spain) and 6.5% (Estonia). In Hungary, the prevalence of problem gambling is 1.9%, with pathological gambling at 1.4%. The socio-demographic characteristics of the results are similar to those of other European countries. Using epidemiological data from the general adult populations of two post-socialist nations, it was possible to compare the results with data from 12 other European countries. Based on the data available, the extremely rapid liberation of the gambling market in the post-socialist countries has led to a similarly swift escalation in associated gambling problems.