Estimating the prevalence of adolescent gambling disorders: A quantitative synthesis and guide toward standard gambling nomenclature

This article reviews the extant published and unpublished studies that estimate the prevalence of adolescent gambling problems in North America. The nine nonduplicative studies identified by our literature search included data collected from more than 7700 adolescents from five different regions of the United States and Canada. In addition to comparing the conceptual and methodological differences that exist among these studies, this article employed a meta-analytic strategy to synthesize prevalence estimates from the existing studies. This analysis revealed that within a 95 percent confidence interval, between 9.9% and 14.2% of adolescents are at risk of developing or returning to serious gambling problems. Similarly, between 4.4% and 7.4% of adolescents exhibit seriously adverse compulsive or pathological patterns of gambling activity. Finally, the discussion proposes a generic multi-level classification scheme to reconcile the divergent classification methods and data reporting strategies. This new multi-level approach to reporting gambling prevalence will facilitate interstudy comparisons among existing estimates of gambling prevalence and help to provide a general data reporting system for future research.     

Developing the DSM-IV-DSM-IV Criteria to Identify Adolescent Problem Gambling in Non-Clinical Populations

This paper presents a revised version of DSM-IV-J criteria for youth, the DSM-IV-MR-J, together with psychometric data stemming from its use in a major prevalence study of adolescent gambling and problem gambling. The case is made for further development and testing of current and emerging instruments to screen for problem gambling in youth, with the aim of establishing one internationally accepted gold standard measure.     

An Empirical Examinination of Jacobs' General Theory of Addictions: Do Adolescent Gamblers Fit the Theory?

The present study examines 817 adolescent High School students' gambling behavior. Participants completed the DSM-IV-J, a gambling screen examining severity of gambling problems along with the High School Personality Questionnaire (HSPQ), the Reynolds Adolescent Depression Scale (RADS) and a questionnaire devised by the authors inquiring about gambling behavior, substance abuse, alcohol consumption, and cigarette smoking. The study seeks to test the Jacobs' (1986) General Theory of Addictions, using problem and pathological adolescent gamblers as the prototype to test the model. The results obtained through path analysis and logistic regression suggest that Jacobs' theory is a plausible and likely explanation for the development of a gambling addiction amongst adolescents. The clinical implications are addressed.     

Prevalence of Adolescent Problem Gambling: A Systematic Review of Recent Research

Previous research has shown that gambling is a popular activity among adolescents. Following a rapid expansion of legalized gambling opportunities and the emergence of new forms of gambling, many researchers have carried out studies on adolescent gambling and problem gambling. The present paper reviews studies that have been conducted worldwide since 2000, and then presents a more detailed picture of adolescent gambling research in Europe, by providing a country-by country analysis. After an extensive search on academic databases and following an exclusion process, 44 studies were identified. The findings showed that 0.2–12.3 % of youth meet criteria for problem gambling, notwithstanding differences among assessment instruments, cut-offs, and timeframes. However, despite this variability, several demographic characteristics were associated with adolescent gambling involvement and problem gambling. It is concluded that a small but significant minority of adolescents have gambling-related problems. Such findings will hopefully encourage more research into youth gambling to further understand the determinants of this phenomenon.     

Further Evidence Concerning the Prevalence of Adolescent Gambling and Problem Gambling in Australia: A Study of the ACT

Abstract

This paper summarises the results of a cross-sectional study of 926 young people (years 7–12, age 11–19) attending State, independent and Catholic schools in the Australian Capital Territory (ACT). The aim of the study was to describe the prevalence of gambling and problem gambling among ACT adolescents and to obtain insights into the social context in which gambling was occurring. Survey results showed that 70% of adolescents had gambled in the previous 12 months and 10% at least weekly. Approximately 4% of adolescents could be described as problem gamblers based upon the DSM-IV-J classification with males and young people from indigenous backgrounds found to be more significantly affected. Most adolescent gambling in the ACT was undertaken either privately or conjunction with others (usually parents or peers), suggesting that existing regulatory provisions are working well. However, the paper nonetheless suggests the need for tighter controls over access to lottery products, greater consumer information in schools to educate young people about the risks of gambling, as well as additional ethnographic research to obtain further insights into how young people gain access to gambling opportunities.     

Adolescent Gambling Behavior: A Prevalence Study and Examination of the Correlates Associated with Problem Gambling

Eight-hundred and seventeen adolescent high school students in the Montreal region completed the DSM-IV-J gambling screen along with a questionnaire devised by the authors inquiring about their gambling behavior, including items assessing the types of activities in which they engage, frequency of involvement, reasons for gambling, and their cognitive perceptions of gambling activities. The results indicate that, in general, 80.2% of students reported having gambled during the previous year, with 35.1% gambling a minimum of once per week. Adolescents reported participating in gambling behavior more often than any other addictive behavior, including cigarette smoking, alcohol consumption, and illicit drug use. The mean age of onset of gambling behavior for the sample was 11.5 years. The rate of pathological gambling was 4.7% as measured by the DSM-IV-J. Pathological gamblers were more likely to have parents with gambling problems and to be engaging in illegal activities than non-pathological gamblers. Gender differences were evident, with males engaging in gambling activities more than females. Differences in game preferences were found, with males more attracted to sports lottery tickets and sports pool betting and females more attracted to lottery tickets and bingo. Gambling awareness and prevention issues are addressed.     

The SOGS-RA vs. the MAGS-7: Prevalence Estimates and Classification Congruence

The purpose of this study was to compare the prevalence rate estimates and congruence in classification status derived from two popular measures of adolescent gambling (SOGS-RA and MAGS-7). Adolescents from three states (Alabama, Mississippi, and Oregon) completed an anonymous questionnaire ( n =1846 high school students total). Results indicate that the prevalence of probable adolescent pathological gambling varied both as a function of instrument and cut-off point utilized for classification (range 1.7%-8.2%). Classification groups (non-problem, at-risk, and problem gamblers) generated by both instruments were found to be associated with reports of gambling frequency, amount of money lost in one gambling occasion, and parental gambling problems. However, concern was raised because the MAGS-7 and the SOGS-RA had little congruence in their three-group classification decisions for specific individuals (e.g., only 20.5% agreement for problem gamblers). To improve clinical utility, an empirical case was made for using the SOGS-RA to generate a fourth group of adolescent gamblers, which we labeled "probable pathological gamblers" (SOGS-RA > or = 6). This group was differentiated from the remaining gambling groups on all the validity indices. The implications and limitations of these findings, as well as future directions, 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.     

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.     

Gambling Involvement and Drug Use Among Adolescents

The literature on youth gambling often notes the relationship of gambling involvement to drug use. The extent of this association and its importance toward advancing knowledge about the origins and course of adolescent gambling are discussed. The authors contend that (a) adolescent gambling, like drug use, may be a normal part of adolescence from a statistical perspective, (b) claims that the prevalence rate of problem/pathological gambling is comparable or higher than the rate of substance use disorders are not supportable at this time given the weaker methodological studies in the gambling area, (c) while research suggests that similar risk factors may be important determinants for both behavior domains, prospective studies of adolescent development are needed to further clarify which factors are unique and common to adolescent gambling, and (d) greater documentation of the harm associated with adolescent gambling is a major barrier to garnering more prevention and treatment resources for this issue.     

Decision-Making,Cognitive Distortions and Alcohol Use in Adolescent Problem and Non-problem Gamblers: An Experimental Study

In the psychological literature, many studies have investigated the neuropsychological and behavioral changes that occur developmentally during adolescence. These studies have consistently observed a deficit in the decision-making ability of children and adolescents. This deficit has been ascribed to incomplete brain development. The same deficit has also been observed in adult problem and pathological gamblers. However, to date, no study has examined decision-making in adolescents with and without gambling problems. Furthermore, no study has ever examined associations between problem gambling, decision-making, cognitive distortions and alcohol use in youth. To address these issues, 104 male adolescents participated in this study. They were equally divided in two groups, problem gamblers and non-problem gamblers, based on South Oaks Gambling Screen Revised for Adolescents scores. All participants performed the Iowa gambling task and completed the Gambling Related Cognitions Scale and the alcohol use disorders identification test. Adolescent problem gamblers displayed impaired decision-making, reported high cognitive distortions, and had more problematic alcohol use compared to non-problem gamblers. Strong correlations between problem gambling, alcohol use, and cognitive distortions were observed. Decision-making correlated with interpretative bias. This study demonstrated that adolescent problem gamblers appear to have the same psychological profile as adult problem gamblers and that gambling involvement can negatively impact on decision-making ability that, in adolescence, is still developing. The correlations between interpretative bias and decision-making suggested that the beliefs in the ability to influence gambling outcomes may facilitate decision-making impairment.     

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.     

Prevalence and Correlates of Gambling Problems Among a Nationally Representative Sample of Brazilian Adolescents

The objectives of the study are: (a) to provide the first prevalence estimates of pathological gambling among Brazilian adolescents using an age-specific instrument in a nationally representative sample; (b) to investigate the extent to which adolescents participate in gambling activities in a developing country; and (c) to correlate different levels of gambling behavior with demographic variables. Multistage cluster sampling selected 3,007 individuals over 14 years of age from Brazilian household population. A total of 661 participants were between 14 and 17 years old. The Lie/Bet Questionnaire and the DSM-IV-MR-J were used for assessing problem and pathological gambling. 2.8% scored positive on the screening questionnaire, while 1.6% were classified as problem and pathological gamblers. Factors associated with problem and pathological gambling were male sex, not currently studying and considering religion as not important. Less than 4 months elapsed between the age of regular gambling involvement and the first gambling problem. Prevalence rates were quite similar from recent studies which used nationally representative samples. The association of problem and pathological gambling with male sex, school drop-out and low religiosity supports the Problem Behavior Theory. The fast progression to problem gambling adds evidence that adolescents may be more vulnerable to the effects of gambling.     

Gambling activities of young Australians: developing a model of behaviour

As more gambling venues open in Australia, youth gambling as problem behaviour has been identified. The aim of this study was to assess youth gambling in a population with easy access to gambling, and to evaluate the adequacy of a model for predicting adolescent gambling frequency and problem gambling. The model comprised a combination of the Theory of Reasoned Action (TRA) (Ajzen & Fishbein, 1980), personality variables (venturesomeness, impulsiveness), and cognitive bias variables derived from Weinstein's (1980) propositions concerning unrealistic optimism about future life events. A sample of 1017 school- and university-based adolescents indicated relatively low frequencies of gambling and low scores on the problem gambling scale, with males scoring higher than females on both measures. The TRA was supported with about 30% of the variance of each of gambling behaviour and problem gambling accounted for by intentions, attitudes, and subjective norms. Personality factors added significantly to the prediction of gambling. The cognitive bias variables, although independently not statistically significant, further contributed to prediction.     

Neurodevelopment,impulsivity, and adolescent gambling

The prevalence of problem and pathological gambling in adolescence and young adulthood has been found to be two- to fourfold higher than in adulthood. Given that these high rates might predict future increases across all age groups, it is important to explore the causes of the elevated rates of problem and pathological gambling among youths. This article reviews evidence for a neurobiological basis for adolescent vulnerability to problem and pathological gambling behaviors. We propose that a common trait motif of impulsivity might underlie phenomenology of pathological gambling, commonly comorbid psychiatric disorders, and related aspects of adolescent behavior. Recent advances in understanding the brain mechanisms involved in motivation, reward, and decision-making allow a discussion of neural circuitry underlying impulsivity. Emerging data indicate that important neurodevelopmental events during adolescence occur in brain regions associated with motivation and impulsive behavior. We hypothesize that immaturity of frontal cortical and subcortical monoaminergic systems during normal neurodevelopment underlies adolescent impulsivity as a transitional trait-behavior. While these neurodevelopmental processes may confer advantage by promoting a learning drive for optimal adaptation to adult roles, they may also confer an increased vulnerability to addictive behaviors such as problem and pathological gambling. An exploration of the developmental changes in neural circuitry involved in impulse control has significant implications for understanding adolescent behaviors and treating problem and pathological gambling among youths.     

Individual, Family, and Peer Correlates of Adolescent Gambling

The primary purpose of this study was to determine the individual, family, and peer factors that correlate with adolescent gambling. High school students from three states ( N = 1,846) completed an anonymous questionnaire assessing the behavior of themselves, their parents, and their peers. Participants also reported on their gambling behavior via the SOGS-RA, which was used to create five adolescent gambling groups (i.e., Non-Gamblers, Non-Problem Gamblers, At-Risk Gamblers, Problem Gamblers, and Probable Pathological Gamblers). In a discriminant function analysis using demographic, individual, family, and peer factors as potential discriminators, two functions emerged that accounted for 94% of the variance between groups. The first function was linear, with the Probable Pathological Gamblers reporting the highest level of peer and parent gambling, susceptibility to peer pressure, conduct problems, binge drinking, suicide attempts, drug use, and being male. The second function highlighted three unique qualities of individuals in the two outlying groups: Probable Pathological Gamblers and Non-Gamblers. These findings suggest that demographic, individual, family, and peer variables are all important correlates of probable pathological gambling in adolescents. Results also support the utility of a five-group classification scheme based on the SOGS-RA. The clinical implications of these results are discussed.     

Problem Gambling Among Adolescent Students in the Atlantic Provinces of Canada

The objectives of the present study were to determine the prevalence of problem gambling among adolescent students in the Atlantic provinces of Canada, and to determine the role of age and deception about legal age status as potential risk factors for problem gambling. In 1998, a total of 13,549 students in grades 7, 9, 10 and 12 in the public school systems of the four Atlantic provinces completed a self-reported anonymous questionnaire that included the South Oaks Gambling Screen-Revised for Adolescents. About 8.2% and 6.4% of adolescent students met the broad definition of at-risk and problem gambling, respectively. About 3.8% and 2.2% of adolescent students met the narrow definition of at-risk and problem gambling, respectively. The prevalence of problem gambling did not vary according to age. Using a fake identification or lying about one's age was found to be an independent risk factor for problem gambling. Playing video gambling machines was the gambling activity associated with the single greatest independent risk of using a fake identification or lying about one's age. It was concluded that deception about legal age status may be a facilitating factor permitting adolescents to gamble to the point of experiencing problems.     

Gender Differences among Adolescents with Gambling-Related Problems

Data from five recent studies using self-reports were merged to explore gender differences in the characteristics of adolescent problem gambling, including comorbidity with other youth problems. The sample consisted of 2,750 male and 2,563 female participants. Male problem gamblers were more likely than females to report signs of psychological difficulties while females were more likely to note behavioural problems as a consequence of their gambling problems. Males and females with severe gambling problems had remarkably similar prevalence rates of depression, substance use and weekly gambling. In the non-problem gambling group, depression was more likely to afflict females whereas substance use and frequent gambling were more prevalent among males.     

Low Self-Control and Co-occurrence of Gambling with Substance Use and Delinquency Among Chinese Adolescents

Relatively little is known about gambling co-morbidity in Asian youth populations. The role of trait self-control in co-morbidity also remains under-explored in the gambling literature. This study examined the association between gambling, substance use and delinquency among Chinese adolescents, and the extent to which these forms of risk behavior are commonly predicted by low self-control. Data from a cross-sectional questionnaire survey of a stratified, random sample of 4,734 high school students aged 12–23 years in Hong Kong were analyzed. The prevalence of gambling pathology, frequency and attitudes showed statistically significant, positive and consistent relationships with tobacco use, alcohol use, and delinquent acts at the p < .001 level. Further analyses revealed that low self-control significantly (p < .001) predicts at-risk/probable pathological gambling, frequent gambling, strong permissiveness toward gambling, heavy use of tobacco and alcohol, and delinquent involvement, even after controlling for the potential shared correlates of socioeconomic characteristics, parental monitoring and peer delinquency. Hence, the concept that gambling problems and strong receptivity to gambling are likely to be part of a general problem behavior syndrome is evinced cross-culturally among young people in a Chinese context. It may also be cost-effective to increase intervention efforts to improve the self-control deficit in adolescents, as this should reduce their gambling and concurrent problem behavior.     

On a Roll: The Process of Initiation and Cessation of Problem Gambling Among Adolescents

As gambling becomes more accessible and acceptable in society, problems associated with gambling and gaming have begun to affect ever increasing numbers of adolescents. Although restricted from most forms of gambling by law, many adolescents are finding a path into problem gambling. Some are becoming compulsive gamblers early in their gambling career, facing a future filled with consequences and problems. Understanding the pathway or process by which these adolescents become engaged in gambling behavior and how they can extricate themselves from this addictive behavior can enhance the efficiency and effectiveness of our interventions. This article offers a perspective on the initiation and cessation of compulsive gambling using the basic elements of the process of intentional behavior change outlined in the Stages of Change from the Transtheoretical Model. The process of initiation of a problematic behavior is similar to the process of modification or cessation of a problematic behavior in terms of these stages of change. With adolescents it is important to distinguish between the process of initiation, which has implications for prevention of gambling problems, and the process of cessation, which often necessitates the assistance of treatment. Creating interventions that parallel the process of change offers the potential for personalizing and potentiating efforts to reduce the prevalence and consequences associated with compulsive or pathological and problem gambling. Application of this model to gambling behavior offers a heuristic that is intriguing and requires substantiation through rigorous research.