The South Oaks Gambling Screen: a review with reference to Australian use

The South Oaks Gambling Screen (SOGS) is a psychometric instrument widely used internationally to assess the presence of pathological gambling. Developed by Lesieur and Blume (1987) in the United States of America (USA) as a self-rated screening instrument, it is based on DSM-III and DSM-III-R criteria. This paper describes the origins and psychometric development of the SOGS and comments critically in relation to its construct validity and cutoff scores. Reference is made to the use of the SOGS in the Australian setting, where historically gambling has been a widely accepted part of the culture, corresponding to one of the highest rates of legalised gambling and gambling expenditure in the world. An alternative approach to the development of an instrument to detect people who have problems in relation to gambling is proposed.     

Reliability,Validity, and Cut Scores of the South Oaks Gambling Screen (SOGS) for Chinese

We examined the reliability, validity, and classification accuracy of the South Oaks Gambling Screen (SOGS) when adopted for use in Chinese. The DSM-IV criteria for pathological gambling served as the standard against which the classification accuracy of the SOGS was tested. A total of 283 Chinese adults in the community and 94 Chinese treatment-seeking gamblers were recruited. The internal reliability of the SOGS was satisfactory for the general sample and acceptable for the gambling sample. The SOGS was correlated with the DSM-IV criteria items as well as psychosocial and gambling-related problems. Relative to the DSM-IV criteria, the SOGS tended to overestimate the number of pathological gamblers in both samples. In general, we were relatively confident that individuals were not pathological gamblers if the SOGS scores were between 0 and 4 and were pathological gamblers if the SOGS were between 11 and 20. There was about 50–50 chance of being pathological gamblers if the SOGS scores were between 8 and 10. However, the probability of individuals being pathological gamblers was about 0.30 if the SOGS scores were between 5 and 7. We proposed a SOGS cut score of 8 to screen for probable pathological gambling in Chinese societies.     

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.     

Antisocial personality disorder and pathological gambling

The prevalence of antisocial personality disorder and its relationship to criminal offenses in pathological gamblers was investigated. A semi-structured interview schedule containing DSM-III criteria for antisocial personality and the California Psychological Inventory Socialisation subscale was administered to a sample of 306 pathological gamblers. Of the total sample, 35% reported no offense. Forty eight percent admitted to the commission of a gambling related offense, 6% to a non-gambling related offense, and 11% to both types of offense. Fifteen percent of subjects met DSM-III diagnostic criteria for antisocial personality disorder. Though these subjects were at greatest risk for committing criminal offenses, offenses were committed independently of DSM-III antisocial personality disorder in the majority of gamblers. It was concluded that features of antisocial personality emerged in response to repeated attempts to conceal excessive gambling and gambling induced financial difficulties.This study was supported by a grant from the Criminology Research Council. The views expressed are the responsibility of the authors and are not necessarily those of the Council. The contribution of Anna Frankova, Research Assistant, is gratefully acknowledged.     

Alexithymia and Gambling: A Risk Factor for All Gamblers?

The purpose of this study was to investigate alexithymia (in relation with depression) in three groups of French gamblers (n = 186) recruited in their gambling location: at the racetracks (n = 80 males; mean age 28.1 years), in the slot machine rooms (n = 65; 29 males, 36 females; mean age 34.6 years), and in the traditional gaming rooms (n = 41 males; mean age 36 years). Gambling behavior was measured by the South Oaks Gambling Screen and DSM-IV criteria for pathological gambling, Alexithymia by the Toronto Alexithymia Scale (TAS-20) and depression with the Beck Depression Inventory (BDI-13). For racetracks and slot machine gambling, pathological gamblers differed from non-pathological gamblers, regarding their alexithymia scores. These results remained stable after controlling for depression scores among the racetracks gamblers only. The relationship between alexithymia and depression depends on the type of pathological gambler. These findings are consistent with the idea of identifying clinically distinct subgroups of gamblers.     

Prevalence Rates of Gambling Problems in Montreal,Canada: A Look at Old Adults and the Role of Passion

The purpose of the present research was to determine the prevalence rate of gambling problems in senior citizens (55 years and older). A community-dwelling sample composed of 810 old adults living in the greater Montreal area in the Province of Quebec completed the Revised South Oaks Gambling Screen (SOGS-R). Results revealed that the 12-month prevalence rate was 1.2% for pathological gambling and 1.6% for at-risk gambling. Although, these rates are comparable to those reported elsewhere in Canada and in the US for senior citizens, the at-risk gambling rate was significantly higher than the current one for the general population of the overall Province of Quebec. Finally, a smaller portion of participants also completed two key items from the Gambling Passion Scale (GPS). Results revealed that obsessive passion was higher for pathological gamblers than for at-risk and non-problematic gamblers, while harmonious passion was lower for pathological gamblers than for at-risk and non-problematic gamblers.     

Alterations in the Emotional Regulation Process in Gambling Addiction: The Role of Anger and Alexithymia

This study aims at the assessment of alexithymia and anger levels in 100 treatment-seeking pathological gamblers compared with controls, who were matched for age, gender and education. Furthermore a positive correlation between alexithymia, anger and severity of gambling disorder and a relationship between gambling behaviour and anger after controlling for alexithymia, are investigated. Finally the role that gender plays in anger in pathological gamblers was also evaluated. Psychological assessment includes the South Oaks Gambling Screen, State-Trait Anger Expression Inventory-2 and the twenty-item Toronto Alexithymia Scale. Statistical analysis of the results shows a higher level of anger in pathological gamblers than in controls, together with alterations in emotional processing. Severity of gambling behaviour positively correlates with alexithymia scores, state-anger and trait-anger. Moreover, a significant contribution of anger in predicting gambling behaviour was suggested after controlling for alexithymia. In conclusion, anger and alexithymia must be regarded as relevant components of the assessment of pathological gamblers, in order to select the best therapeutical strategies to prevent self-defeating behaviours and to reduce drop-out from treatments.     

Screening for college problem gambling in Chinese societies: psychometric properties of the Chinese version of the South Oaks Gambling Screen (C-SOGS)

A total of 979 Chinese college students were recruited in order to examine the psychometric properties of the Chinese version of the South Oaks Gambling Screen (C-SOGS). The C-SOGS was internally consistent and correlated with gambling-related problems and negative mental health status. Results of likelihood ratios (LRs) and receiver operating characteristic (ROC) curve supported the C-SOGS as a valid screening instrument for probable pathological gambling. Using the DSM-IV criteria for pathological gambling, the conventional cut score of 5 on the C-SOGS showed satisfactory sensitivity, specificity and false negative rates. This cut score identified 85% of the true positives and 95% of the true negatives. In general, the C-SOGS overestimated the number of pathological gamblers relative to DSM-IV criteria. Future research on Chinese gambling should build on current empirical work on the SOGS to refine the C-SOGS for use with Chinese populations.     

Crime,antisocial personality and pathological gambling

To investigate the hypothesized causal relationship between pathological gambling and gambling-related illegal behaviors, 77 patients seeking behavioral treatment for excessive gambling and 32 members of Gamblers Anonymous were administered a structured interview schedule. Data on the incidence, nature and extent of both gambling and non-gambling related illegal behaviors was obtained and DSM-III (A.P.A., 1980) criteria for Antisocial personality were used as the measure of sociopathy.Of the sample, 54.1% admitted to a gambling related offense and 21.1% were charged. Results showed that 14.6% met DSM-III criteria for Antisocial Personality, Four subgroups were subsequently identified; gamblers who committed no offense (36.7%), gambling only offenses (40.4%), non-gambling only offenses (9.2%) or both gambling and non-gambling offenses (13.7%). Significantly more subjects from the gambling plus non-gambling related offenses subgroup were classified as antisocial personalities.Of pathological gamblers who committed offenses, two thirds reportedly did so as a direct consequence of gambling induced problems. Subjects reporting gambling-only related offenses showed a significant increase in antisocial features after adolescence suggesting that antisocial features emerge as a secondary phenomenon to pathological gambling behavior patterns.Acknowledgments: This study was made possible by a grant from the Criminology Research Council, Australian Institute of Criminology.     

Risk-Taking,Delay Discounting,and Time Perspective in Adolescent Gamblers: An Experimental Study

Previous research has demonstrated that adult pathological gamblers (compared to controls) show risk-proneness, foreshortened time horizon, and preference for immediate rewards. No study has ever examined the interplay of these factors in adolescent gambling. A total of 104 adolescents took part in the research. Two equal-number groups of adolescent non-problem and problem gamblers, defined using the South Oaks Gambling Screen-Revised for Adolescents, were administered the Balloon Analogue Risk Task (BART), the Consideration of Future Consequences (CFC-14) scale, and the Monetary Choice Questionnaire (MCQ). Adolescent problem gamblers were found to be more risk-prone, more oriented to the present, and to discount delay rewards more steeply than adolescent non-problem gamblers. Results of logistic regression analysis revealed that BART, MCQ, and CFC scores predicted gambling severity. These novel finding provides the first evidence of an association among problematic gambling, high risk-taking proneness, steep delay discounting, and foreshortened time horizon among adolescents. It may be that excessive gambling induces shortsighted behaviors that, in turn, facilitate gambling involvement.     

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

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

Prevalence of pathological gambling and associated problems in individuals who visit non-gambling video arcades

The objective of the present study was to investigate the gambling behavior of individuals who frequent non-gambling video games arcades. One hundred and twenty two subjects (mean age of 19.2 years (SD=5.5); males constituted 82.8%) who spend time in arcades completed the South Oaks Gambling Screen and the Jacob's Health Survey. The results showed that 10.7% were identified as probable pathological gamblers and 14.8% were problem gamblers. The frequency of visits to arcades for non-gambling activities appeared to be correlated with the extent to which individuals gamble, and is furthermore associated with pathological gambling. The rate of pathological gamblers who frequent arcades is more than twice as high as the rates reported in other studies with adolescents and adults.This research was partially supported by grants from the Fonds Richelieu and Loto-Québec awarded to the first author.     

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.     

Pre/Early Adolescent Onset of Gambling and Psychosocial Problems in Treatment-Seeking Pathological Gamblers

This study examined the association between pre- or early-adolescent onset of gambling and severity of gambling and psychosocial problems in treatment-seeking adult pathological gamblers. A total of 236 pathological gamblers entering outpatient treatment completed the South Oaks Gambling Screen (SOGS) and the Addiction Severity Index (ASI). Using a quartile split procedure, gamblers who began gambling during their pre- or early-adolescent years (mean age of 10.5 years; 1st quartile) were compared to gamblers who began gambling later in life (mean age of 23.0 years; 2nd to 4th quartiles). Compared to later onset gamblers, pre/early adolescent onset gamblers reported increased severity of psychiatric, family/social, and substance abuse problems on the ASI. They were more likely to report cognitive problems (trouble understanding, concentrating, or remembering), suicidal ideation, and a history of inpatient psychiatric treatment, and were less likely to be satisfied with their current living situation. Pre/early adolescent onset gamblers also reported earlier age of initiation of drinking, and were more likely to have received treatment for an alcohol use disorder, and to have used cannabis and cocaine in their lifetimes. Taken together, these data suggest that pre/early adolescent-onset of gambling may be a risk factor for later-life psychiatric, family/social, and substance abuse problems in treatment-seeking pathological gamblers.     

The prevalence of pathological gambling in Galicia (Spain)

Since 1977, when gambling was legalized in Spain, the amount of money spent on it has increased each year. Expenditures on gambling are now more than 3 billion pesetas per year. This paper provides the results of a study on the prevalence of pathological gambling in the Galicia region of northwest Spain, with a representative random sample (N=1,615) from the seven largest cities of Galicia. The prevalence of pathological gambling was 1.7% utilising the DSM-III-R diagnostic criteria. An additional 1.6% were problem gamblers, 0.6% excessive social gamblers and 1% exexcessive gamblers. The results suggest that slot machines are the most addictive form of gambling. Pathological gamblers are homogeneously distributed in the population with the exception that males and upper income family membership are overrepresented. Alcohol and cigarette consumption were higher among pathological gamblers than in the general population.This research was funded by the Service of Mental Health and Drug Abuse of the Health Authority of Galicia (SERGAS, Consellería de Sanidade). The author is grateful to M. José Fuentes, M. Carmen Carro, M. Angeles González, M. Carmen Lorenzo, Ana Pérez, Ana Sáinz, and Beatriz Torres for her help in collecting the data. I also thank Iain Brown for his helpful comments and English revision of this article. Paper presented at the Society for the Study of Gambling, London, November 1991.     

Geographical accessibility to gambling venues and pathological gambling: an econometric analysis of pachinko parlours in Japan

The relationship between geographical accessibility to gambling venues and the prevalence of pathological gambling is still unknown. This study aimed to reveal this relationship in Japan as well as its variation by subpopulation. A cross-sectional study was conducted, based on an original web-based survey to understand the level of pathological gambling depending on accessibility to pachinko parlours. Pathological gamblers were measured using the Japanese version of the South Oaks Gambling Screen. Accessibility to gambling venues was defined as the number of pachinko parlours within a 1.5 km radius from home. Moreover, the study adopted the instrumental variable approach to solve the potential endogeneity problem. The results showed that the accessibility was not significantly associated with pathological gambling in general, but that the effects of accessibility varied by subpopulation. Accessibility was significantly and positively correlated with pathological gambling for men and people in low-income areas, but this was not so for women and people in high-income areas. The study’s findings show the importance of the neighbourhood environment and could help in implementing more effective interventions for pathological gamblers.     

The Role of Metacognition in Pathological Gambling: A Mediation Model

Pathological gambling involves multitudinous costs related to financial, legal, and public health care aspects, as well as to specific psychological disorders. Despite the overall evidence suggesting that comorbid disorders represent a risk factor for pathological gambling, there is scant evidence on the appropriate treatments for gamblers with such disorders. In this context, metacognitive therapy is an interesting approach because it considers psychological disorders as a result of the activation of perseverative cognitive processes and attentional strategies in response to inner events. Several studies report that metacognition is associated with different psychological problems. This study investigated the relationship among comorbid disorders, metacognition, and pathological gambling. 69 pathological gamblers at the first hospital admission and 58 controls drawn from general population (matched for age, gender, education) completed a battery of self report instruments: Symptom Checklist-90-R, Metacognition Questionnaire 30, South Oaks Gambling Scale. Compared to controls, pathological gamblers showed higher level of comorbid symptomatology and metacognition. Correlation analyses showed that: comorbid symptomatology and metacognition were positively and significantly correlated with pathological gambling; metacognition was positively and significantly associated with comorbid symptomatology. Mediation analysis indicated that dysfunctional metacognitive strategies could have an indirect effect on pathological gambling mediated by concurrent psychological disorders. These findings provide some implications for gambling treatment programs: pathological gamblers should be screened for psychiatric disorders, and metacognitive therapy could be considered a correct treatment of pathological gamblers. Metacognitive therapy might lead to the reduction of the pathological gambling by the diminishing of the concurrent psychological disorders.     

DSM-IV and the South Oaks Gambling Screen: diagnosing and assessing pathological gambling in Turkey

The main purpose of this study was to investigate the effectiveness of the DSM-IV diagnostic criteria and the South Oaks Gambling Screen (SOGS) in identifying Turkish pathological gamblers. Fifty-nine subjects participated in the study. The subjects were diagnosed as either pathological gamblers or not (comparison group) through the use of the DSM-IV criteria and were given the Turkish version of the SOGS. Four of the ten DSM-IV criteria were found to be problematic in the diagnosis of Turkish pathological gamblers. The data concerning reliability and validity of the Turkish version of the SOGS suggested that the SOGS can be used as a reliable and valid instrument in identifying Turkish pathological gamblers. Most (16 out of 20) of the items of the SOGS appear to work well in discriminating pathological gamblers from the subjects in the comparison group. In the case of the two DSM-IV criteria and the four SOGS items that failed to discriminate, cultural factors seemed to be responsible for the failure.     

Brief Communications Analysis of a Casino's Self-Exclusion Program

As gambling facilities become more available, the number of pathological gamblers increases. Effective therapeutic and preventive interventions should be developed and systematically evaluated. Self-exclusion programs may be a useful means to facilitate self-control among problem gamblers. This paper describes the characteristics of individuals who decided to bar themselves from a Canadian casino. Two hundred twenty individuals participated in the present study and completed a questionnaire including four sections: (1) socio-demographic data, (2) the South Oaks Gambling Screen, (3) gambling habits, and (4) prior experiences with the self-exclusion program. According to the SOGS, 95% of the participants were classified as severe pathological gamblers on the SOGS (Mean score = 9.87). Furthermore, based on self-reported observation, 30% of the participants completely stopped gambling once enrolled in this program. No one scored within the interval of non-problem gamblers. Suggestions to improve self-exclusion programs are discussed.     

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.