Dropouts and continuers in Gamblers Anonymous: Part four. Evaluation and summary

In this fourth part of a study of dropouts from Gamblers Anonymous, the design, aims and rationale of which are outlined in part 1 (Brown, 1985b) experiences of GA by a sample of dropouts who had attended more than one meeting are analyzed and compared with similarly obtained responses from a group of continuing attenders who had not gambled for at least one year. The overall pattern of findings from the three prior parts of the study is interpreted as suggesting that

1. Gamblers anonymous may be better at coping with those whose gambling has been severely excessive and had led to many problems. However GA's approach is not so easily accepted and therefore not so effective with those who seek help at an earlier stage in the development of their problems.
2. Gamblers Anonymous may work better with those who have few relapses or best with those who have none at all. Although it may be very helpful in avoiding relapses, it may be less helpful in dealing with them when they do occur.

problems of the representativeness of the sample, of generalizing to Gamblers Anonymous as a whole, and of arguing from associations to causes are discussed. A general picture of the organization as a whole is presented.     

Really not god: Secularization and pragmatism in Gamblers Anonymous

The paper argues that despite maintaining the image of a twelve-step organization, the central theme of the history of Gamblers Anonymous (GA) in the United States is the increasing secularization of the program of the recovery. The paper documents the increasing secularization and pragmatism of Gamblers Anonymous, as reflected in key documents, despite the spiritual vision of its founding member. The author speculates on why Gamblers Anonymous took a secularized development path. Further research is called for.This research was supported in part by NIAAA post-doctoral grant, 2 T32 AA07240-11, at the Alcohol Research Group (ARG), Berkeley, California. I would like to thank ARG, Mary Phillips, the anonymous reviewers and editor of theJournal of Gambling Studies, Kathy Deierlein, Bob Yamashita, and anonymous members of Gamblers Anonymous. This paper is a revision of one presented at the Fifth National Conference on Gambling Behavior in Duluth, Minnesota during July, 1991.     

Criminal offenses in gamblers anonymous and hospital treated pathological gamblers

The purpose of this study was to compare the nature and prevalence of gambling and non-gambling related offenses in samples of pathological gamblers seeking behavioural treatment from a hospital-based program and those attending Gamblers Anonymous. A semi-structured interview schedule obtaining demographic data and details of the nature, frequency, and consequent legal action of criminal offenses committed was administered to 152 consecutive hospital treated pathological gamblers, and 154 Gamblers Anonymous attendees who volunteered to participate in the study. Of the total sample, 59% admitted a gambling-related offense, and 23% to a conviction. There was no difference in the proportion of hospital treated and Gamblers Anonymous subjects who offended. The most common gambling-related offenses were larceny, embezzlement and misappropriation. Gamblers committed a median of ten offenses over an average ten year period of pathological gambling with a median value of $ A 300¹ per offense. The median value for each non-gambling-related offense was $ A 130. Except for the significantly older mean age of Gamblers Anonymous subjects, hospital treated gamblers did not differ from Gamblers Anonymous attenders on relevant demographic features or parameters of gambling behaviour. Findings were interpreted to suggest a possible causal link between pathological gambling and the commission of non-violent property offenses.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.     

Dropouts and continuers in Gamblers Anonymous: Life-context and other factors

The design, aims and rationale are outlined of a follow-up study of dropouts from Gamblers Anonymous. A cohort of those attending for the first time and dropping out after more than one meeting was contacted and the cooperators given a structured interview examining factors which may have contributed to decisions to dropout. A comparison group of continuers from the same meeting who had been totally abstinent for at least a year were given the same structured interviews. This first of four parts examines life context factors making it more difficult to maintain attendance, commitment to the treatment program, perceived pre-meeting expectations and reasons for coming, impacts of the first meeting, effects of pressures to maintain attendance and the influence of spouses.     

Recovery,reinstatement, serenity: The personal account of a compulsive gambler

A lawyer, investment banker, and certified public accountant who committed crimes to support his gambling addiction describes the process of reinstatement after suspension, the feelings of frustration and despair, and the support he received from Gamblers Anonymous.Editor's Note: Adherence to the principles of the Gamblers Anonymous program made it incumbent upon the author to maintain his anonymity for this article.     

Who Are the Anonymous? Involvement and Predictors of Gamblers Anonymous Attendance Among Disordered Gamblers Presenting for Treatment

Gamblers Anonymous is the most widely available form of support for disordered gambling. Although chapters exist worldwide, knowledge of how attendees interact with the program is limited. The present study aimed to investigate involvement in Gamblers Anonymous among attendees, motives for attendance, and overall satisfaction with the program. Furthermore, potential gambling-related predictors of attendance versus deciding not to attend Gamblers Anonymous were investigated. A treatment-seeking sample of disordered gamblers (N?=?512) from São Paulo, Brazil completed a series of self-report measures including an author-compiled Gamblers Anonymous survey. From the sample, 141 gamblers reported attending Gamblers Anonymous over the previous 30 days. An examination of involvement, satisfaction, and motives for attending Gamblers Anonymous was conducted, followed by regression analyses to assess predictors of attendance and satisfaction with the program. The majority of attendees (80%) reported some satisfaction with the program. The most common motive for attending Gamblers Anonymous was related to relapse prevention. Regression analyses revealed that greater gambling severity and number of days gambled were associated with not attending Gamblers Anonymous while giving testimonials was strongly related (OR?=?6.18) to satisfaction with the program. The findings of this study contribute to the literature on Gamblers Anonymous. In particular, that members derive great satisfaction from the program and see it as a way to strengthen their abstinence goals. However, despite high satisfaction, the results also suggest that most members were passively involved in the program. More research that assesses the effectiveness of Gamblers Anonymous as either a stand-alone or adjunct treatment is needed.     

Suicidal behavior among members of Gamblers Anonymous

A national sample of 500 members of Gamblers Anonymous was surveyed by mail in order to gather information on suicidal history. One hundred sixty two usable surveys were returned representing 32.4% of the original sample. Compulsive gamblers who had a history of suicidal preoccupation began gambling at an earlier age than nonsuicidal gamblers and were more likely to have stolen to support their gambling. They also tended to have addicted relatives and children more than nonsuicidal gamblers did. The data suggest that those gamblers who had been suicidal tend to be more serious gamblers than nonsuicidal respondents.     

Pathological gamblers and their spouses: Problems in interaction

Two parallel self-administered surveys were distributed at three conferences of Gamblers Anonymous. One survey was for members of Gamblers Anonymous and the other was for members of GamAnon. Of the approximately 450 respondents, 302 were completed by the compulsive gambler and the spouse (N=151 couples). This article is a report on these 151 couples. The survey focused on two time periods — the gambler's time of torment, a phase spent in plumbing the depths of dread and despair, and the period of recovery following abstinence from gambling. Specific areas covered focus on the gambler's gambling activities, the spouse's awareness of problems, psychosomatic and emotional difficulties of the couple, sexual relationships, children's attitudes, and financial management. The respondents also indicated their need for specific therapy and workshops which could be provided by professional mental health counselors or at Gamblers Anonymous conferences.Based on a paper presented at the Seventh International Conference on Gambling and Risk Taking, Reno, August 22–26, 1987.     

Insurance problems and pathological gambling

A survey of 241 members of Gamblers Anonymous was conducted in order to find out the impact of pathological gambling on the insurance industry and whether Gamblers Anonymous reverses that impact. Fifty-two percent of the respondents cashed in, surrendered, lapsed or had policies revoked for non-payment. Forty-six percent borrowed on or used the cash value of their life insurance policies while gambling. Forty-seven percent admitted to some form of insurance related fraud, embezzlement or arson in connection with their gambling. The cost to the insurance industry was estimated at 66 billion dollars in surrendered policies and 33 billion dollars in fraud. Attendance at Gamblers Anonymous reversed much of this loss as members picked up new policies and engaged in programs of restitution after attendance. A discussion is made of the insurance related activities in terms of the usage of options up to and including suicide. Possible insurance industry responses are presented.     

Changing Spousal Roles and Their Effect on Recovery in Gamblers Anonymous: GamAnon,Social Support,Wives and Husbands

This paper examines changing spousal roles and their effects upon recovery in Gamblers Anonymous (GA). It is based upon a qualitative study designed to gage uniformity as well as variations in approaches to recovery in GA. Interviews were conducted with 39 GA members (26 men, 13 women; mean age 56.5 years). Though the study was based in the Toronto area, only 13 interviews involved participants from that region. Phone interviews were conducted with GA members from various regions of both Canada and the US. GamAnon, GA’s sister fellowship, has been designed for anyone affected seriously by someone’s gambling problem. In practice, GamAnon comprises mostly women––spouses of male GA members––who traditionally have taken a keen interest in the ways in which their husbands achieve and maintain abstinence from gambling. Changing spousal roles have led to fewer women joining GamAnon, as many opt instead to part with troubled spouses. As well, more women are attending GA than in the past, typically with husbands who are disinclined to join GamAnon. All of this has drastically altered how GA members pursue recovery. These changes and their implications are discussed.     

Examining the relationship between spousal involvement in Gam-Anon and relapse behaviors in pathological gamblers

The present investigation focused on Gamblers Anonymous (GA) members in Ohio to ascertain whether or not spousal participation in Gam-Anon, the companion support group, decreased the gambler's relapse into gambling behavior. A cross-sectional survey of 43 GA members was conducted using a self-administered questionnaire. While no significant difference was found in the relapse of those gamblers with or without a spouse in Gam-Anon, the degree to which the gambler had engaged in other addictive-like behaviors in the past did appear to be related to relapse. Those gamblers who had not relapsed reported significantly more engagement in past addictive-like behaviors (excessive overeating, drinking, and using drugs) than those who had relapsed. Additionally, their spouses had also engaged in addictive-like behaviors in the past. Discussion suggests possible explanations for the findings. Implications are drawn for both outcome measures and research with self-help groups.     

Pathological gambling and associated patterns of crime: Comparisons with alcohol and other drug addictions

The pattern of convictions for various categories of crime in the population of the United Kingdom was compared with the corresponding pattern in a sample of addictive gamblers drawn from Gamblers Anonymous in the U.K. A distinctive pattern of income-generating crime was found to be statistically associated with pathological gambling. This pattern was compared with other distinctive patterns associated with the intake of alcohol and with various other drugs and it was found to resemble most closely that of addiction to narcotic drugs.The possible role of gambling as a contributory cause of crime is discussed in the light of what is known of the issues surrounding other addictions as causes of their distinctive patterns of crime.The content and presentation of this paper benefited from the comments of J. Gillies and A.J. Weir, both of the Department of Psychology, University of Glasgow. The collection of the data would have been impossible without the active encouragement and assistance of the General Services Board of Gamblers Anonymous, U.K., its chairman G. Moody and the National Committee of Gamblers Anonymous, U.K.     

Delinquency among pathological gamblers: A causal approach

In a comprehensive research project on gamblers in self-help groups in West Germany one object of investigation was the question of whether or not pathological gambling has a criminogenic effect. 54.5% of the 437 members of Gamblers Anonymous interviewed stated that they had committed illegal actions in order to obtain money for gambling. Comparisons of this sub-group with those interviewees who did not admit having committed criminal offences show distinct differences: Those who admitted illegal action were more excessive in their gambling behavior and experienced a higher degree of subjective satisfaction through gambling. They also showed a more pronounced problem behavior and more psychosocial problems because of gambling. A multiple regression within the framework of path analysis was computed in order to explore causal links between pathological gambling and delinquency. The results support the hypothesis that pathological gambling can lead to delinquent behavior. Forensic implications are discussed.This article is a revised version of a paper presented at the Eighth International Conference on Risk and Gambling in London, U.K., August 15–17, 1990.The content and presentation of this article has benefited from the comments of Agnes Roemer, Department of Psychology, University of Bremen.     

The association between comorbidity and outcome in pathological gambling: a prospective follow-up of recent quitters

A naturalistic sample of pathological gamblers (N = 101) who recently quit gambling was followed prospectively for a year (follow-up rate 80%). Lifetime mood disorders were identified in 61% of participants and 73% and 48% had lifetime alcohol use and drug use disorders, respectively. Current prevalence rates, however, were much lower. Current mood disorders were found for 20% and 7% had a current alcohol disorder and 7% a current drug use disorder. Age of onset for substance use disorders was earlier than gambling disorders but mood disorders were equally likely to predate or follow gambling disorders. Lifetime mood disorder was associated with a longer time to achieve 3 months of stable abstinence. Participants who were currently in treatment or attending Gamblers Anonymous and the small number of participants with current alcohol disorders were also more likely to achieve abstinence earlier. The results underscore the importance of increasing our understanding of the role of comorbid disorders in the recovery process from gambling problems.     

Delabeling and relabeling in Gamblers Anonymous: Problems with transferring the Alcoholics Anonymous paradigm

Exploratory data from both structured and unstructured interviews with members of Alcoholics Anonymous and Gamblers Anonymous, as well as additional data from previous observations, suggest that the recovery rate of A.A. is higher than that of G.A.. Since the programs are virtually the same an examination of the social context of the labeling process reveals that the more readily available use of the medical model for both the alcoholic and the significant others of the alcoholic are likely significant differences between the compulsive gambler and the compulsive drinker.An embryonic version of this paper was presented at the Second Annual Conference on Gambling, Lake Tahoe, August 1975. The authors thank Henry Lesieur, Robert Custer, and the anonymous reviewers ofThe Journal of Gambling Behavior for their comments and suggestions. We give special thanks to Dan, Howie, Jeanne, Berdell, Barbara, John, Swede, Happy Jack, Nancy, Skip, and many other anonymous members of G.A. and A.A. for their help and cooperation in this study.     

Multiple Co-occurring Behaviours among Gamblers in Treatment: Implications and Assessment

A substantial portion of gamblers in treatment may have co-occurring mental health disorders including substance use disorders, especially alcohol dependency, personality disorders, affective disorders, anxiety disorders and impulse control disorders. Co-occurring mental health disorders affect treatment seeking, the treatment process and its outcome, quality of life and functioning in many mental health disorders. Participants in this study were 78 adults enrolled in state-supported out-patient services for pathological gambling and current Gamblers Anonymous attendees. The majority of participants (76.6%) had co-occurring behaviours; 55.8% had multiple co-occurring behaviours. Participants with multiple co-occurring behaviours were more likely to report that a co-occurring behaviour increased the severity of their gambling symptoms. A dose/response relationship between number of co-occurring behaviours and severity of gambling problems was found. Co-occurring behaviours can interact with gambling behaviour. Brief, validated screening instruments are available for screening and diagnosing co-occurring behaviours among gamblers presenting for treatment.     

The selective adaptation of the alcoholics anonymous program by Gamblers Anonymous

This paper is largely based on a year long observation study of Gamblers Anonymous and Alcoholics Anonymous meetings in northern California. The paper argues, contrary to popular assumption, that Gamblers Anonymous is significantly different from Alcoholics Anonymous. Differences, in members' consciousness for example, are discussed. The paper contends that although there is some12 step consciousness in G.A., the dominant consciousness ispage 17 consciousness. The significant differences are attributed to the selective adaptation of the Alcoholics Anonymous program. Several consequences of these differences, such as the central role of a language of the self in A.A. and not in G.A., are highlighted.This research was supported by NIAAA post-doctoral grant, 2 T32 AA07240-11, at the Alcohol Research Group, Berkeley, California. I would like to thank everyone at ARG for the wonderfully supportive and intellectually stimulating atmosphere at ARG. I would like to thank especially Mary Phillips, Ron Roizen, Kim Bloomfield, Robin Room, Mike Hilton, Laura Schmidt, John Rumbarger and David Newmark for listening patiently to the unfolding story. I would also like to thank Rachel Volberg and Richard Rosenthal, M.D. for comments on an earlier draft. Comments from the anonymous reviewers and the editor ofJournal of Gambling Studies were also quite useful. Most of all, though, I would like to thank the anonymous members of A.A. and G.A. I, however, take responsibility for the arguments advanced in the paper. This paper is a revision of one presented at theEighth International Conference on Risk and Gambling in London, England, August, 1990.     

Pathological Gambling: Psychosomatic,emotional and marital difficulties as reported by the Gambler

Two parallel self-administered surveys were distributed at three conferences of Gamblers Anonymous. One survey was for members of Gamblers Anonymous and the other was for members of GamAnon. Approximately 500 respondents completed the surveys. This article is a report of some of the data from the gamblers' survey. This survey focused on two time periods of the compulsive gambler's life—during the desperation phase of the illness (Custer, 1982) and the phase following a period of abstinence from gambling. Specific areas covered in this preliminary report focus on the psychosomatic problems encountered by the gambler, emotional difficulties, sexual estrangement, and the need for mental health services. It is anticipated that some of these needs can be met through training or therapy sessions in professional gambling treatment centers and at Gamblers Anonymous conferences.This article is a revised version of a paper presented at the Sixth National Conference on Gambling and Risk Taking, Atlantic City, New Jersey, December 1984.Robert Yaffee computer scientist, was assisted by senior research assistants: Nancy Frankel, Danny Frankel, Deborah Becker, Douglas Rosen, Leslav Giermanski, Jaime Beauchamp, and Thomas Reingold. Other research assistants included Joseph Lautner, Trudy Myers, Arvind Chawla, and John Morales. To all of these individuals, the National Foundation for Study & Treatment of Pathological Gambling acknowledges its gratitude for their contribution to this project.     

Pathological gambling: Psychosomatic,emotional and marital difficulties as reported by the spouse

Two parallel self-administered surveys were distributed at three conferences of Gamblers Anonymous. One survey was for members of Gamblers Anonymous and the other was for members of GamAnon. Approximately 500 respondents completed the surveys, with 215 having completed the questionnaire for the spouse. This article is a report of some of the data from the spouse's survey. This survey focused on two time periods of the spouse's life — during the desperation phase of the gambler's illness (Custer, 1982) and the phase following a period of abstinence from gambling. Specific areas covered in this report focus on the psychosomatic problems and emotional difficulties encountered by the spouse, marital and familial estrangement, financial management, and the need for mental health services. It is anticipated that some of these needs can be met through training or therapy sessions in professional gambling treatment centers and at Gamblers Anonymous conferences.The work on this spouse survey represents a collective effort to enhance the understanding of the relationship between the pathological gambler and the spouse during the desperation phase of the illness and during recovery. Dr. Lorenz developed and implemented the survey. Yaffee organized the data processing, statistical programming, and analysis of the survey. For dedicated and outstanding assistance, special thanks must be given to our senior research assistants, who prepared the codebook and program for this spouse survey: Maria Ycasiano, Leslav Giermanski, Roger Meier, Raisa Rot and Steven Rubenstein. Thanks must also be given to Norberto Colon, Paula Diamond, Edwin Castro, Abdul Beydoun, and Fallan Rhim for their valuable assistance in entering, checking, and cleaning the data prior to analysis. Appreciation for the program written by Joseph Lautner, to check for misalignments in the data file, and the assistance provided by Deborah Becker on this project, is also gratefully acknowledged. To Dr. Thomas Wesselkamper, Chairman of the Hunter College Science Department, for permission to run this project, and all of the aforementioned research assistants, the authors express their sincere gratitude.