Controlled Gambling for Pathological Gamblers

Despite its high prevalence, pathological gambling often remains untreated. It is estimated that only 10% of the pathological gamblers identified in prevalence studies will enter treatment. Within this small proportion, a high percentage will drop out. Despite the facts that some researchers argue against abstinence as the unique treatment goal and that regaining control appears to be possible for some pathological gamblers, abstinence has been the only treatment goal in most problem gambling interventions thus far. This paper examines the avenue of controlled gambling embedded in a harm reduction context as a viable solution for some pathological gamblers.     

Gambling Increases Self-Control Strength in Problem Gamblers

In two studies it is demonstrated that, in the short-term, slot machine gambling increases self-control strength in problem gamblers. In Study 1 (N = 180), participants were randomly assigned to either play slot machines or engage in a control task (word anagrams) for 15 min. Subsequent self-control strength was measured via persistence on an impossible tracing task. Replicating Bergen et al. (J Gambl Stud, doi:10.1007/s10899-011-9274-9, 2011), control condition participants categorized as problem gamblers persisted for less time than did lower gambling risk participants. However, in the slot machine condition, there were no significant differences in persistence amongst participants as a function of their gambling classification. Moreover, problem gambling participants in the slot machine condition persisted at the impossible tracing task longer than did problem gambling participants in the control condition. Study 2 (N = 209) systematically replicated Study 1. All participants initially completed two tasks known to deplete self-control strength and a different control condition (math problems) was used. Study 2 results were highly similar to those of Study 1. The results of the studies have implications for the helping professions. Specifically, helping professionals should be aware that problem gamblers might seek out gambling as a means of increasing self-control strength.     

Gender by Preferred Gambling Activity in Treatment Seeking Problem Gamblers: A Comparison of Subgroup Characteristics and Treatment Outcomes

Problem gambling is a growing public health concern and treatment incompletion levels remain high. The study aims to support and extend previous studies in relation to the heterogeneity of the gambling population based on gender and gambling type, and the implications of subgroup differences on treatment outcomes. Additionally, the concept of drop-out is addressed in terms of categorical treatment measures. The empirical findings are examined in the context of the theoretical framework of the pathways model. Participants were recruited from the Statewide Gambling Therapy Service and stratified into subgroups based on gender and gambling mode preference [Electronic Gambling Machines (EGM) or track race betters]. Baseline predictors collected and analysed using multinomial logistical regression included demographic information as well as gambling variables, while treatment outcomes consisted of three therapist rated measures. Significant differences between the subgroups were found for age, marital and employment status, gambling duration, alcohol use and the Kessler 10 measure of psychological distress. Specifically, male track race gamblers were younger, married, employed, had a longer duration of gambling, higher alcohol use and lower psychological distress relative to EGM users. No difference was found in any of the treatment outcomes, however, consistent with previous studies, all subgroups had high treatment incompletion levels. The findings demonstrate the importance of screening, assessing and treating problem gamblers as a heterogeneous group with different underlying demographics and psychopathologies. It is also hoped future studies will continue to address treatment incompletion with a re-conceptualisation of the term drop-out.     

The Categorical Stability of Gambling Motives Among Community-Recruited Gamblers: A Longitudinal Assessment

Over the past decade, several motivational models have been proposed to explain the role of motives in gambling disorder. In the model captured by the four-factor Gambling Motives Questionnaire Financial (GMQ-F), gamblers are described as being primarily motivated to gamble for ‘coping’, ‘enhancement’, ‘social’, and ‘financial’ reasons. Although this model has received significant empirical support; to date, research assessing the role of motives in gambling disorder has been primarily cross-sectional in nature. Thus, the extent to which gambling motives remain stable over time has yet to be explored. In the current study, the stability versus fluidity of self-assessed gambling motives was investigated using the Quinte Longitudinal Study, a longitudinal dataset of gambling behaviour collected over 5 years. Gambling motives of 2795 gamblers were examined over all five annual assessments. The total proportion of gamblers who stayed in the same primary motive category across each of the 5 consecutive assessments was 22%, indicating substantial fluidity in category membership. Substantial movement between categories was seen for each GMQ-F group, as well as an additional group of non-classified motives. Logistic regression analyses suggest that greater resistance to gambling fallacies significantly predicted stability between the baseline assessment and a follow-up 1 year later, but gambling severity did not. Potential limitations in the study design and opportunities for future research are discussed.     

Gambling Motivation and Passion: A Comparison Study of Recreational and Pathological Gamblers

The aim of this study was to examine the structural relationship among gambling motivation, gambling passion, and behavioral intentions to gamble between recreational and pathological gamblers. Specifically, this study aimed to shed light on the different ways in which gambling motivation and affective attitude are associated with recreational and pathological gamblers. Using a purposive sampling method, 400 subjects were selected for and participated in this study during their visits to a casino. Study results echoed the notion of distinctive and separate gambling motivations and passions between recreational and pathological gamblers. Also, results identified specific areas to which casino operators or policy makers should pay special attention in developing effective marketing strategies to promote responsible gambling.     

Gambling Motives in a Representative Swedish Sample of Risk Gamblers

Motives for gambling have been shown to be associated with gambling involvement, and hence important in the understanding of the etiology of problem gambling. The aim of this study was to describe differences in gambling motives in different subgroups of lifetime risk gamblers, categorized by: age, gender, alcohol- and drug habits and type of game preferred, when considering the level of risk gambling. A random Swedish sample (n = 19,530) was screened for risk gambling, using the Lie/Bet questionnaire. The study sample (n = 257) consisted of the respondents screening positive on Lie/Bet and completing a postal questionnaire about gambling and motives for gambling (measured with the NODS-PERC and the RGQ respectively). When considering the level of risk gambling, motives for gambling were not associated with gender, whereas younger persons gambled for the challenge more often than did older participants. Card/Casino and Sport gamblers played to a greater extent for social and challenge reasons then did Lotto/Bingo-gamblers. EGM-gamblers played more for coping reasons than did Lotto/Bingo gamblers. However, this association turned non-significant when considering the level of risk gambling. Moderate risk gamblers played for the challenge and coping reasons to a greater extent than low risk gamblers motives for gambling differ across subgroups of preferred game and between gamblers with low and moderate risk. The level of risk gambling is intertwined with motives for gambling and should be considered when examining gambling reasons.     

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.     

Excitement-seeking Gambling in a Nationally Representative Sample of Recreational Gamblers

Excitement-seeking and related constructs have been associated with heavier gambling and negative health measures in problem and/or pathological gamblers. Most adults gamble recreationally and an understanding of the relationship between excitement-seeking as a motivation for gambling amongst subsyndromal gamblers has significant public health implications. Logistic regression analyses were used to examine a national sample of past-year recreational gamblers (N = 1,476) to identify characteristics distinguishing gamblers acknowledging gambling for excitement (“Excitement-seeking Gamblers” or EGs) and gamblers denying gambling for excitement (“Non-excitement-seeking Gamblers” or NEGs). EGs were more likely than NEGs to report alcohol use and abuse/dependence, any substance abuse/dependence, incarceration, large gambling wins and losses, more frequent and varied gambling, and symptoms of pathological gambling (i.e., at-risk gambling). Together, these findings indicate that EGs are more likely than NEGs to demonstrate problems in multiple areas characterized by impaired impulse control.     

In Search of Executive Impairment in Pathological Gambling: A Neuropsychological Study on Non-treatment Seeking Gamblers

Pathological gambling is characterized by a persisting maladaptive and recurrent behavior with severe social and psychological consequences. There is evidence of strong comorbidity with psychiatric manifestations as well as cognitive mainly involving executive functions. This study aimed to investigate impairment in executive functions and working memory, and personality traits in a sample of Greek gamblers. Twenty-four men involved in various gambling activities were recruited from ecological settings as probable pathological gamblers. They were assessed with a comprehensive neuropsychological battery involving several executive tasks, the Zuckerman–Kuhlman Personality Questionnaire, the Hospital Anxiety Depression Scale, and the Difficulties in Emotion Regulation Scale. An age- and education-level matched group of 21 men without history of habitual gambling served as controls. As a group, gamblers displayed significantly lower scores on indices of inhibition, decision making and self-reported emotional awareness, and scored higher on impulsivity/sensation seeking personality traits. Notably, gamblers scored similarly or significantly higher on measures of verbal and visuospatial working memory, cognitive flexibility, processing speed, verbal fluency, and sustained attention. Overall, we argue that gamblers do present with specific cognitive deficits, but there is no evidence for a generalized executive impairment, and further stress the importance of investigating cognitive, personality, and psychiatric aspects of gambling on the basis of an ecologically valid sampling.     

How Do Gamblers End Gambling: Longitudinal Analysis of Internet Gambling Behaviors Prior to Account Closure Due to Gambling Related Problems

Objective: To examine behavioral patterns of actual Internet gamblers who experienced gambling-related problems and voluntarily closed their accounts. Design: A nested case–control design was used to compare gamblers who closed their accounts because of gambling problems to those who maintained open accounts. Setting: Actual play patterns of in vivo Internet gamblers who subscribed to an Internet gambling site. Participants: 226 gamblers who closed accounts due to gambling problems were selected from a cohort of 47,603 Internet gamblers who subscribed to an Internet gambling site during February 2005; 226 matched-case controls were selected from the group of gamblers who did not close their accounts. Daily aggregates of behavioral data were collected during an 18-month study period. Main outcome measures: Main outcomes of interest were daily aggregates of stake, odds, and net loss, which were standardized by the daily aggregate number of bets. We also examined the number of bets to measure trajectory of gambling frequency. Results: Account closers due to gambling problems experienced increasing monetary loss as the time to closure approached; they also increased their stake per bet. Yet they did not chase longer odds; their choices of wagers were more probabilistically conservative (i.e., short odds) compared with the controls. The changes of monetary involvement and risk preference occurred concurrently during the last few days prior to voluntary closing. Conclusions: Our finding of an involvement-seeking yet risk-averse tendency among self-identified problem gamblers challenges the notion that problem gamblers seek “long odds” during “chasing.”     

Gambling Behaviour and the Prevalence of Gambling Problems in Adult EGM Gamblers when EGMs are Banned. A Natural Experiment

In this article, findings of a panel study among former EGM gamblers are discussed. The data were collected in two waves during 2007, and 1293 people, 18 years or older, participated. The background for the study was the Norwegian ban on EGMs from 1 July 2007, and the aim was to investigate how this ban affected gambling involvement and problem levels in the sample. The analysis shows that gambling participation, gambling frequencies and gambling problems were reduced after EGMs disappeared from the market. There was no indication of the development of an illegal EGM market, or of substitution of EGMs with other types of gambling. A reduction in other types of gambling is interpreted as an indication of synergetic effects between games. Reduced gambling participation among the most active EGM gamblers, and among risk gamblers, shows that the reductions in gambling availability had an effect even on highly involved gamblers.     

Gambling Patterns and Problems of Gamblers on Licensed and Unlicensed Sites in France

In 2010 France enacted a law to regulate supply and consumption of online gambling. Its primary aim was to protect citizens from gambling-related harm. This study aims to assess differences in gambling patterns and related harm between online gamblers who use licensed versus unlicensed sites. Participants (N = 3860) completed a self-administered online survey on gambling practices. Pairwise logistic regressions examined the association between the legal statuses of gambling sites people patronized and demographic variables and gambling types. Multivariate logistic regression models explored associations between gambling patterns and related problems according to the legal status of sites people have gambled on. Overall, 53.7 % of online gamblers report gambling exclusively on licensed sites. Those who bet on regulated activities on unlicensed sites, versus licensed sites, are more likely to be female, younger, less educated, inactive in the labor market and are more likely to perceive their financial situation to be difficult. Gambling on unlicensed sites is associated with more intense gambling patterns and more gambling-related problems compared to licensed sites. Findings demonstrate that gambling activities carried out on state licensed sites are associated with less overall harm to gamblers. Implications of these findings on future policy are discussed and prospective research directions are outlined.     

Breaking Bad: Comparing Gambling Harms Among Gamblers and Affected Others

This article examines gambling harms from both gamblers and affected others’ perspectives. Participants (3076 gamblers and 2129 affected others) completed a retrospective survey that elicited information on harms they experienced from gambling across their lifetime. Their responses were analyzed through testing measurement invariance, estimating item-response theoretic parameters, calculating percentages, confidence intervals, and correlations, as well as regressions. The results indicated large commonalities in the experience of harms reported by gamblers and affected others. Further, gamblers appeared to ‘export’ about half of the harms they experienced to those around them. The findings also provided detailed profiles of evolving harms as problem gambling severity varies.     

A Comparison of Horse-Race, Bingo, and Video Poker Gamblers in Brazilian Gambling Settings

In the present study Brazilian gamblers from different settings were compared on socio-demographic characteristics, gambling behavior, and use of drugs. The SOGS was administered to 171 subjects at bingo (BG), video poker (VP), and horse-racing clubs (HR) of São Paulo. BG concentrated most women, VP the youngest and single gamblers, and HR the lowest income subjects. More VP than HR or BG gamblers reported taking time off work to gamble, as well as returning another day to win back lost money. They also had a higher number of scorable responses on the SOGS. The differences observed suggest that VP gamblers bear a greater risk of developing a pathological gambling pattern. The authors suggest that measures should be taken aimed at the prevention of pathological gambling, particularly among the young population of video poker gamblers.     

Clustering Finnish Gambler Profiles Based on the Money and Time Consumed in Gambling Activities

Gambling involves consumption of gamblers’ money and time. Gamblers are a heterogeneous group, and in addition to grouping gamblers based on personality factors, it is also important to find different gambler profiles with respect to their gambling behavior. Using the nationally representative survey ‘Finnish Gambling 2011’ (N = 4484), this article studies the subtypes of Finnish gamblers based on the frequency of gambling and the amounts of money and time used in different gambling forms. Cluster analysis reveals six profiles of gamblers, from infrequent gamblers to omnivorous gamblers. In the further analysis of the clusters, it was found that the highest problem gambling prevalence was in the groups of sport betting + electronic gaming machine gamblers and omnivorous gamblers, which were also both dominated by men. Certain gambling consumption patterns and risk factors for problem gambling are related to both socio-demographic backgrounds of the gamblers as well as the structural and situational characteristics of the games. The results have implications for the prevention of problem gambling, as some consumption patterns may be connected with the probability of developing gambling problems.     

Impulsivity and Gambling Type Among Treatment-Seeking Disordered Gamblers: An Explorative Study

Several studies have found that certain traits of impulsivity are associated with gambling disorder, and influence its severity. Furthermore, it has been suggested that some forms of gambling, particularly electronic gambling machines, are particularly widespread among pathological gamblers. In the present, exploratory study, we aim to clarify the role played by impulsivity in influencing the choice of specific gambling activities, by examining the relation between individual dimensions of impulsivity, and the choice of specific gambling activities in a clinical population. 100 consecutively admitted pathological gamblers at the National Problem Gambling Clinic in London (UK) in 2014 were administered the UPPS-P and BIS-11 impulsivity questionnaires, the Problem Gambling Severity Index, and underwent a structured interview concerning their gambling activities in the month and year prior to assessment. The correlation between individual gambling activities and impulsivity dimensions was analyzed both at a bivariate level, and using logistic regression. We found a significant correlation between Negative Urgency, Motor impulsivity and low-stakes machine gambling on multivariate analysis. Negative urgency (i.e. the tendency to act impulsively in response to negative affect), and Motor impulsivity (a tendency to rash action and restlessness) might be mediating factors in the choice of electronic gambling machines, particularly among patients whose gambling is escape-oriented. Structural and situational characteristics of gambling machines, particularly the widespread availability of low-stakes—rather than high-stakes—gaming machines, might concur to the choice of this form of gambling among individuals who present higher negative urgency and restlessness.     

Subtypes of Problem Gamblers,Sociocultural Factors,and Availability of Gambling

Finnish treatment-seeking gamblers were examined in light of predominant problem gambler subtype models. “Psy science” oriented problem gambler subtypes were found to be considerably influenced by gambling cultures and treatment traditions in the countries from which the mainstream problem gambler research originates. Thus, models that emphasize the psychopathology of the individual might cause some friction when applied to countries like Finland with a quite particular gambling culture and addiction treatment system that traditionally functions on a social work basis. It is suggested that specialists helping problem gamblers should acquire local knowledge with which to complete psychiatrically oriented scientific knowledge.