Compulsive gambling: Structured family intervention

Family intervention has been an effective procedure for getting alcoholics into treatment for more than twenty years. Now this technique is being used with compulsive gamblers. Because the gambling disorder is so easy to hide, the patient seems to be further into the illness by the time the family seeks help. Furthermore, because the gambling offers intermittent rewards, the denial in both the patient and family appears to be stronger than found with most alcoholics.During the intervention it is important to tell the compulsive gambler why the help of a professional was sought; what changes have been observed by family members and friends as a result of his/her gambling; how family relationships have been affected; what is feared will happen if he/she doesn't get help; and what each family member hopes will happen once the gambler is in recovery.Most concerned persons enter family interventions with the sole purpose of getting the gambler into treatment. However, since this is a family disease, ethically the primary goal of family intervention needs to be to getsomeone into treatment, if not the individual suffering with the disease then one or more of those concerned persons suffering from it.     

Compulsive gambling and the medical model

The medical model as a conceptual and operative approach to compulsive gambling is discussed. The terms medical model and disease are defined and the practical implications of their application to compulsive gambling are explored. Special attention is given to the addictive disease concept. Finally, a variety of objections to the medical model are described, but it is concluded that the many individual and social advantages of the medical model make it the preferred conceptualization at our present state of knowledge.     

Compulsive gambling and the changing military law

Military courts have had to face the issue of compulsive gambling in criminal court-martial proceedings. The military recently switched from the liberal ALI definition of insanity to the much more stringent standards of the federal Insanity Defense Reform Act. However, military courts have not even allowed in expert testimony, holding the relevance of compulsive gambling has not been generally accepted in the scientific community. The rules involving extenuation or mitigation in sentencing allow much more leeway. Although compulsive gambling cannot be used as the basis for a defense of insanity in military courts, defense lawyers will continue to raise the issue in attempting to obtain lesser punishments for their military clients.B.S. Loyola College, J.D. Univ. of MD, Active duty Judge Advocate General's Corps, four years currently selected for promotion to Colonel, USAR. Partner, Stark and Little.B.A. 1982, Gettysburg College; J.D., 1987, Univ. of Balto.; Associate, Stark and Little, Baltimore, MD; member of the Baltimore City, Md. State, and Am. Bar Associations.     

Compulsive gambling and the law: From sin to vice to disease

The idea that compulsive gambling is a disease is in direct conflict with the dominant view in the law that gambling is a vice. Under the traditional view individuals who gamble to excess are morally weak and deserving of punishment. The recognition of pathological gambling as an official mental disease or disorder by the American Psychiatric Association in 1980 created an irreconcilable contention: American law never punishes an individual for being sick. The conflict can be seen in every area of the law and even between judges sitting in the same courtroom. The most dramatic disputes have been over the insanity defense; but, the disease argument has been raised, sometimes successfully, in other criminal cases, to mitigate sentencing, in attorney disbarments, tax cases, bankruptcies, divorces, personal injury claims, and, most significantly, in claims against casinos. The legal disputes will spread and become even more heated as the disease diagnosis becomes more generally accepted.     

Regulation and the management of risk in commercial gambling in Great Britain

The regulation of commercial gambling in Great Britain is the responsibility of the Gambling Commission, the regulatory agency created by the Gambling Act 2005. This article examines the risk model that it has developed in order to assess operator risks to the Act's licensing objectives. These are to prevent gambling from becoming a source of crime, to ensure that gambling is fair and open, and to protect children and other vulnerable people from being harmed or exploited by gambling. The article discusses four factors that affect the implementation of this model: operator compliance, the regulatory environment, the regulatory toolkit and the Commission's approach to its regulatory responsibilities. Its regulatory ideology sits squarely within the neo-liberal mode of regulation that has been pursued in Great Britain since the 1980s. By reference to political and public disquiet concerning gaming machines, the article analyses the tensions between the state, the regulator, the gambling industry and its consumers to which this mode of regulation gives rise. The article examines the challenges that the Commission faces in seeking to adopt a regulatory stance that is defensible both in terms of the protection of the public and the demands of a liberal market economy.     

Exploring the relationship between gambling,debt and financial management in Britain

The issue of how and why gamblers end up in debt has received comparatively little attention in the literature. Data from the 2007 Adult Psychiatric Morbidity Survey (APMS) revealed that although problem gamblers were more likely than non-problem gamblers to have forms of financial debt, just under two-thirds of problem gamblers (62%) reported having no debt. Using a qualitative approach, this study aimed to explore the issue from the perspective of gamblers themselves through interviews with 27 purposively sampled gamblers drawn from participants who took part in the APMS and the British Gambling Prevalence Survey 2010. Analysis, using the Framework method, suggested the existence of four kinds of gamblers categorized by their approach to gambling spending and their approach to their general spending: ‘controlled gamblers’, ‘uncontrolled gamblers’, ‘uncontrolled spenders’ and ‘chaotic spenders’. Also proposed on the basis of these data is an ecological model which aims to capture the different levels of personal and environmental factors that influenced people's financial decisions, including cognitive factors, control and compulsion, normative spending, resource and financial management, and the credit environment. The implications for practice are also discussed.     

Increasing public awareness of pathological gambling behavior: A history of the National Council on Compulsive Gambling

This article provides a history of the National Council on Compulsive Gambling. It includes a discussion of ambivalence toward gambling, the development of the disease concept, increased public participation and awareness of gambling, the enactment of state legislation, and public education strategies of the council.     

Gender,gambling and problem gambling

With data from a 1989 Iowa survey (N=1,011), adult male and female respondents are compared on their problem gambling, its correlates, as well as their gambling behavior. Gambling behavior means its scope, frequency, wagering and leisure time spent at gambling. Women's gambling behavior was lower than that of men, due to their having a narrower scope of gambling behavior, but the genders were not significantly different on frequency, wagering and time spent at gambling. Women and men did not differ significantly on problem gambling. Problem gambling is measured as loss of control over gambling, and consequences due to gambling as well as gambling behavior. Women and men did differ significantly, however, on several predictors of problem gambling. Women's estrangement from a conventional lifestyle and integration into a social world of gambling appeared to help explain their problem gambling. Alcohol consumption appeared to be a more important predictor for men than women. The genders shared the attitude that the odds can be beat as well as being big spenders as predictors of their problem gambling. The results are interpreted with practitioners' efforts to prevent and treat problem gambling in mind.This research was partially supported by the Iowa Department of Human Services and the Na tional Institute of Mental Health (1 RJ01 MH50369-01A1). The authors are grateful to anonymous re viewers and the editor of this journal for many helpful suggestions.     

Public opinion towards gambling and gambling regulation in Australia

In recent years, public opinion towards gambling has become a more important factor in shaping public policy. Using a national public opinion survey conducted in Australia in 2011, this paper examines public opinion towards gambling in general and towards the government regulation of gambling in particular. Australia is an important case study because of the internationally high prevalence of gambling among the public, combined with a strong regulatory framework. Public opinion is measured by a reduced form of a scale first developed in Britain. The results confirm the generally negative views that the public holds towards gambling, which have been found internationally. In addition, the Australian public is open to the introduction of further restrictions on gambling. Overall, the public views the liberalization of gambling as having moved as far as most citizens find acceptable; to meet public expectations, future policies need to address more adequately the negative social consequences associated with problem gambling.     

National survey on lifestyles and gambling in Serbia: gambling participation and problem gambling in adult population

The aim was to examine the association of socio-demographic and lifestyle characteristics with gambling severity level. The study was a part of the National Survey on Lifestyles in Serbia: Substance Abuse and Gambling, in 2014. The sample consisted of 5385 individuals. Based on the Problem Gambling Severity Index (PGSI) score participants were divided into non-problem gambling, low-/moderate-risk gambling and problem gambling. Prevalence of problem gambling was 0.5%, which was associated with having poor self-perceived financial status, having moderate or high risk for psychological distress, playing sports betting, casino games and slot machines. Low/moderate gambling was associated with having poor self-perceived financial status, number of drinking days per year, using any illicit drugs in the last 30 days, playing sports betting, slot machines, and online betting. Programmes of early detection of problem gambling should be developed, and regulation of availability of slot machines and sports betting.     

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.     

Ways in which gambling researchers receive funding from gambling industry sources

Using data from computer-assisted telephone interviews with 1000 18- to 24-year old Australians, the structure underlying participation in 12 gambling activities was investigated. Factor analysis indicated that activities were differentiated into those that are chance-based, involve selecting a winner and involve individuals' skills. Gambling problems, assessed using a four-item factor, were related to participation in the two skill-based activity types. Males participated in these more than females. Age was positively related to participating in activities involving selecting a winner and negatively to those involving individuals' skills. Participation in activities associated with the three factors was differentially related to individual difference factors along with family and peer participation in, and support for, gambling. Together the results indicate that young Australians do not view gambling activities homogeneously and future research should focus on the predictors and outcomes of different types of gambling among this age group.     

A generational comparison of problem gambling and gambling attitudes among older adult gambling venue patrons

Gambling is a popular leisure activity for older adults (55+), and existing research suggests that overall older adults are less prone to problem gambling compared to younger cohorts. People born after World War II are now beginning to reach retirement age. The purpose of this article was to explore age-related cohort differences between people born from 1943 to 1960 compared to those born from 1925 to 1942 in their attitudes and behaviours related to gambling. This study employs a large sample (2103) of older adults collected at gambling locations across Southern Ontario, Canada in 2013. Comparisons were made using Pearson’s chi-squared tests for categorical variables and independent samples t-tests for continuous variables with logarithmic transformations for highly-skewed variables. Those of the 1943 to 1960 cohort showed significantly higher problem gambling scores and per visit spending, but lower numbers of visits per year. There was no discernible pattern between cohorts in terms of attitudes toward gambling. Assumptions of lower risk of problem gambling among older adults will have to be re-evaluated as the post-war generation becomes an ever greater proportion of older adults.     

Models of gambling and gambling addictions as perceptual filters

Models, in the sense of loosely entertained clusters of beliefs, attitudes, assumptions and expectations which direct the work of researchers and clinicians, also act as perceptual filters, tending to focus the attention of those who use them on certain aspects of reality and relegating to the background or ignoring altogether other aspects of the field of study and action. The central characteristics of social learning and of medical models are briefly reviewed and they are compared as perceptual filters for their distorting effects on research in gambling and in gambling addictions and on intervention strategies for problem gamblers. It is concluded that the exclusive predominance of any one model leads to the impoverishment of both research and intervention.     

Forms of gambling,gambling involvement and problem gambling: evidence from a Swedish population survey

The purpose of this study was to explore the association between problem gambling (PG) and participation in different forms of gambling in order to elucidate relationships between PG, gambling involvement and gambling intensity. Using data from the first wave of the Swedish Longitudinal Gambling Study (Swelogs) (n = 4,991), the study tested four hypotheses, namely that (1) some forms of gambling are more closely associated with PG than other forms; (2) high gambling involvement is associated with PG; (3) gambling involvement is positively associated with the intensity of gambling; and (4) the relationship between gambling involvement and PG is influenced by the specific forms of gambling in which individuals participate. All four hypotheses were supported. More specifically, the study found that while many PGs regularly participate in multiple forms of gambling, half of PGs participate regularly in only one or two forms of gambling. The study concluded that some forms of gambling are more closely associated with problem gambling than other forms, and that gambling policy and regulation, as well as the development of responsible gambling initiatives, should focus on these forms.     

Pathological gambling: A comparison of gambling at German-style slot machines and “Classical” gambling

German-style slot machines and related legal issues are described. On the basis of a survey on 437 members of self-help groups (Gamblers Anonymous) in Germany, slot machine gamblers were compared with casino gamblers on such variables as sociodemographic data, gambling behaviour, financial expenditure, emotional experience while gambling, symptoms of pathological gambling, psychosocial consequences and gambling related delinquency. The casino gamblers' gambling behaviour is financially more extensive. There were similarities regarding the emotional intensity of the gambling experience. However the casino gamblers show more pronounced symptoms of pathological gambling and the psychosocial consequences of their gambling behaviour are more severe. In spite of these differences, the data show that for young people slot machines can be as stimulating and therefore as dangerous as casino gambling. The young slot machine gambler runs a similar risk of acquiring a pathological gambling habit as the casino gambler.I would like to thank Dr. Gerhard Meyer for his support and his comments on the first draft of this article which is based on data from a research project led by him.     

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.     

Cognitive distortions in heavy gambling

A sample of 38 regular and heavy gamblers, recruited through advertisements and not seeking treatment, were asked to describe special strategies, techniques or rituals that they used to increase their chances of winning at gambling in an open-ended interview. The mean South Oaks Gambling Screen Score for the sample was 7.7 with 64% of the sample scoring higher than 4. Their responses reflected multiple means by which the individual believed they were able to control (i.e., active illusory control, passive illusory control), reframe (i.e., interpretive control), or predict (i.e., probability control, predictive control) gambling outcomes. A larger number of cognitive distortions was associated with playing games in which skill was potentially a component (e.g., cards, sports) than in non-skill games (e.g., lotteries) as well as a positive family history of gambling. There were no sex differences. Implications of these findings for the cognitive psychopathology of gambling are discussed.