The Relationship Between Problem Gambling and Attention Deficit Hyperactivity Disorder

Recent studies indicate that treatment-seeking problem gamblers display elevated rates of ADHD and that adolescents who screen positive for ADHD are more likely to engage in gambling, develop gambling problems, and experience a greater severity in gambling problems. This study aimed to (a) compare the prevalence of ADHD in treatment-seeking problem gamblers to the general population; (b) investigate the relationships between ADHD and problem gambling severity, cluster B personality disorders, motor impulsivity, alcohol use, substance use, gender, and age; and (c) investigate the degree to which these factors moderate the relationship between ADHD and problem gambling severity. Participants included 214 adults (154 males, 58 females, 2 unspecified) who sought treatment for their gambling problems at a specialist gambling agency in Melbourne, Australia. Almost one-quarter (24.9 %) of treatment-seeking problem gamblers screened positively for ADHD, which was significantly higher than the 14 % prevalence in a community sample. ADHD was significantly positively correlated with problem gambling severity, motor impulsivity, and cluster B personality disorders, but was not associated with alcohol and substance use, gender or age. None of the factors significantly moderated the relationship between ADHD and problem gambling severity. These findings suggest that a considerable proportion of treatment-seeking problem gamblers report ADHD and that their clinical profile is complicated by the presence of high impulsivity and cluster B personality disorders. They highlight the need for specialist gambling agencies to develop screening, assessment, and management protocols for co-occurring ADHD to enhance the effectiveness of treatment.     

Young Adult Gambling Behaviors and their Relationship with the Persistence of ADHD

Young adulthood is a period renowned for engagement in impulsive and risky behaviors, including gambling. There are some indications that young adults exhibit higher gambling rates in comparison to older adults. Problem gambling has also been linked to ADHD. This longitudinal study examines the relationship between gambling and ADHD among an epidemiological sample of young adults (n = 235; males = 179, females = 56) aged 18-24. Results indicate that individuals who report childhood ADHD symptoms which persist into young adulthood experience greater gambling problem severity than participants with no ADHD or those with non-persistent ADHD.     

Association Between Internet Gambling and Problematic Internet Use Among Adolescents

The study objectives were to evaluate the correlates and psychosocial implications of internet gambling among adolescents, as well as the association between internet gambling and problematic internet use. A cross-sectional study design was applied among a random sample (N = 484) of adolescents (71.2% boys; 28.8% girls; mean age ± standard deviation, SD = 14.88 ± 0.55 years). Self-completed questionnaires, including internet gambling practices, internet use characteristics, Young Internet Addiction Test, and Strengths and Difficulties Questionnaire were utilized. The prevalence of internet gambling was 15.1%. Internet gambling was associated with psychosocial maladjustment, including Abnormal Conduct Problems (gender adjusted odds ratio, AOR = 3.83; 95% confidence interval, 95% CI: 1.86–7.92) and Borderline Peer Problems (AOR = 2.04; 95% CI: 1.09–3.85). The likelihood of concomitant problematic internet use was significantly higher among internet gamblers (AOR = 1.81; 95% CI: 1.03–3.19). Multivariate regression analyses indicated that among all characteristics of internet use assessed, utilizing the internet for the purposes of gambling practices was independently associated with problematic internet use among adolescents (AOR = 3.43; 95% CI: 1.40–8.39). Thus, the study findings suggest that adolescents who participate in internet gambling practices are more likely to concomitantly present with problematic internet use.     

Is Speeding a Form of Gambling in Adolescents?

Speeding is a major contributor to motor vehicle accidents, which are the leading cause of death in adolescents. This study compares the extent to which adolescents with gambling behavior and substance use reported driving over the posted speed limits (“speeding”). Florida adolescents ages 13–17 (n = 1051) were surveyed, and asked about gambling activities, problems related to gambling, substance use, demographic questions, and speeding. Of the 562 respondents who were drivers, the gender distribution was 52.1% male and 47.9% female. Of those respondents, 76.9% were Caucasian, 6.8% were African American, 10.1% were Hispanic, and 6.1% were Native American/Asian/Other. Simple correlation analysis revealed that self-reported speeding is significantly related to gambling behavior and substance use. When a linear regression model was used, four factors showed the most significant influence on self-reported speeding: past year gambling tendency, age, trouble with the police due to drinking, and tranquilizer usage. Gambling behavior and high-risk speeding (driving ≥ 10 mph over speed limit) also were noted to be positively correlated. Our data indicate a relationship between risky driving, gambling, and other risk-taking behaviors in adolescents, and support the hypothesis that speeding may be a form of gambling behavior in this age group.     

Impulsivity and pathological gambling across depressive versus bipolar disorders

Impulsivity has been implicated in the development of pathological gambling (PG); sensation seeking and urgency in particular have predicted gambling pathology in undergraduate and psychiatric samples. In light of the relevance of both depressed and elevated mood to impulsivity and gambling, the components of impulsivity associated with PG across mood disorders warrants investigation. The aim of the current investigation was to examine the association between impulsivity and gambling pathology severity across depressive versus bipolar disorders. A total of 275 participants with lifetime depressive or bipolar disorder completed measures of impulsivity and gambling. Urgency was consistently associated with gambling pathology indicators; lack of perseverance was specifically associated with gambling pathology within participants with depressive disorders. Reckless action during negative mood is associated with gambling pathology across mood disorders, whereas difficulty remaining focused is associated with PG solely within depressive disorders. Impulsivity and affective comorbidity may inform current understanding of PG.     

Co-morbidity Between Gambling Problems and Depressive Symptoms: A Longitudinal Perspective of Risk and Protective Factors

In both adolescents and adults, gambling problems and depressive symptoms co-occur and share some common risk factors (e.g., impulsivity and socio-family risk). However, little is known about (1) the developmental course of the co-morbidity of these problems; (2) variables that may moderate the effect of these common risk factors on gambling problems and depressive symptoms. Of specific interest could be individuals’ social relationships with significant others such as parents and friends, because research shows that they moderate the effect of other risk factors on gambling problems and depressive symptoms. The goals of this study were to: (a) identify developmental pathways for gambling problems and depressive symptoms, with a focus on co-morbidity; (b) assess the moderating effect of relationship quality with parents and friends on the link between common risk factors and the trajectories of gambling problems and depressive symptoms. Study participants were 878 males. Predictors were assessed during childhood and adolescence and gambling problems and depressive symptoms were assessed in late adolescence and young adulthood. Latent class analysis revealed four distinct joint trajectories of gambling problems and depressive symptoms. Subsequent logistic regression revealed that impulsivity predicted membership in all pathogenic trajectories, and quality of the relationship with parents predicted membership in depressogenic trajectories. In addition, we found that the membership in the comorbid trajectory can be predicted by an interaction between friendship quality and socio-family risk.     

Maternal Positive and Negative Interaction Behaviors and Early Adolescents' Depressive Symptoms: Adolescent Emotion Regulation as a Mediator

This study examined the relation between mothers' positive and negative interaction behaviors during mother–child interactions and the emotion regulation (ER) and depressive symptoms of their adolescent offspring. Event‐planning (EPI) and problem‐solving interactions (PSI) were observed in 163 mother–adolescent dyads, and adolescents also provided a self‐report of ER responses and depressive symptoms. Sequential analyses of mother–adolescent behaviors during the interaction tasks indicated that adolescents with more depressive symptoms were more likely to reciprocate their mothers' negative affective behaviors. Adolescents whose mothers displayed less positivity and more negativity (i.e., less frequent positive and more frequent negative behaviors) during the EPI displayed more emotionally dysregulated behaviors in the PSI and reported more frequent maladaptive ER responses. Adolescents whose mothers behaved negatively toward them more frequently during mother–adolescent interactions also reported more depressive symptoms. The frequency with which adolescents engage in maladaptive ER responses mediated the association between maternal negativity and adolescents' concurrent depressive symptoms.     

Depressive Symptoms and Gambling Behavior: Mediating Role of Coping Motivation and Gambling Refusal Self-Efficacy

Understanding the variables that contribute to the comorbidity of depression and gambling behaviors is important in developing effective intervention strategies for those who experience gambling-related problems. The purpose of this study was to implement core concepts from Jacob’s general theory of addiction and the social cognitive theory in a multiple mediation model. Specifically, we tested two models to examine whether coping motivation and refusal self-efficacy mediated the relationship between depressive symptoms, gambling related problems, and days gambled. Data was collected from 333 undergraduate students at a large public Midwest university, participating in a larger clinical trial. Analyses indicated a direct effect between depressive symptoms and gambling related problems. Depressive symptoms were found to have a significant indirect effect through coping motivation and gambling refusal self-efficacy on gambling related problems and days gambled. These results provide further support regarding the mechanisms through which depressive symptoms may increase risk for problematic gambling behavior.     

Do High School Students in India Gamble? A Study of Problem Gambling and Its Correlates

Studies from the West suggest that significant numbers of high school students gamble, despite it being illegal in this age group. To date, there have been no studies on the prevalence of gambling among senior high school and higher secondary school students in India. This study reports point prevalence of gambling and its psychosocial correlates among high school students in the State of Kerala, India. 5043 high school students in the age group 15–19 years, from 73 schools, were selected by cluster random sampling from the district of Ernakulam, Kerala, South India. They completed questionnaires that assessed gambling, substance use, psychological distress, suicidality, and symptoms of Attention Deficit Hyperactivity Disorder (ADHD). Of a total of 4989 completed questionnaires, 1400 (27.9 %) high school students reported to have ever gambled and 353 (7.1 %) were problem gamblers. Of those who had ever gambled, 25.2 % were problem gamblers. Sports betting (betting on cricket and football) was the most popular form of gambling followed by the lottery. Problem gamblers when compared with non-problem gamblers and non-gamblers were significantly more likely to be male, have academic failures, have higher rates of lifetime alcohol and tobacco use, psychological distress, suicidality, history of sexual abuse and higher ADHD symptom scores. Gambling among adolescents in India deserves greater attention, as one in four students who ever gambled was a problem gambler and because of its association with a range of psychosocial variables.     

Predicting Gambling Problems from Gambling Outcome Expectancies in College Student-Athletes

While previous research has suggested the potential importance of gambling outcome expectancies in determining gambling behaviour among adolescents, the predictive ability of gambling outcome expectancies has not yet been clearly delineated for college-aged youth. The current study aims to explore the relationships between gender and outcome expectancies in the prediction of gambling severity among college student-athletes. Data from the National Collegiate Athletic Association (NCAA) study assessing gambling behaviours and problems among U.S. college student-athletes were utilized. Complete data was available for 7,517 student-athletes. As expected, male college student-athletes reported more gambling participation as well as greater gambling problems than their female counterparts. Findings showed positive relationships between the outcome expectancies of financial gain, and negative emotional impacts and gambling problems. That is, those who endorsed more items on the outcome expectancy scales for financial gain and negative emotional impacts also tended to endorse more gambling-related problems. Findings also showed a negative relationship between outcome expectancies of fun and enjoyment, and gambling problems over and above the variance accounted for by gender. Those with gambling problems were less likely to have the expectation that gambling would be fun than those without gambling problems. Despite NCAA efforts to curb gambling activity, the results suggest that college student-athletes are at risk for over-involvement in gambling. Therefore, it is important to explore gambling outcome expectancies within this group since the motivations and reasons for gambling might be able to inform treatment initiatives.     

Gambling Behaviour in Adolescents with Learning Disorders

The present study examined the prevalence of disordered gambling behaviours in a community-based sample of adolescents (N = 532) living in eastern central Ontario. Of particular interest was examining the hypothesis that adolescents with learning disorders are at elevated risk for disordered gambling. Rates of disordered gambling in male adolescents with learning disorders were found to be significantly higher than adolescents without learning problems, even after controlling for negative affectivity and ADHD symptomatology. The implications for treatment and intervention of gambling problems in adolescence are discussed.     

Self-perception of Gambling Problems among Adolescents Identified as At-risk or Problem Gamblers

The relative influence of perceived familial addictive behaviors and personal gambling behaviors on adolescents' self-perceptions of gambling problems was examined. Students from five high schools in Connecticut (N = 3,886) were surveyed. Of those between the ages of 14 and 17 who scored two or more on the South Oaks Gambling Screen--Revised for Adolescents (n = 532; 72% male; 43% Caucasian), 14.3% reported having a current or past problem with gambling. Wagering larger amounts in a single day, gambling on a daily basis, and perceived presence of a family member with a gambling problem were associated with increased odds of self-perception of a gambling problem. Thus, adolescents who may be less likely to be identified for prevention efforts (due to lack of engagement in high stakes gambling or the real/perceived absence of a problematic gambler in the home) appear less likely to perceive a gambling problem. To advance prevention and treatment strategies, the apparent discrepancy between adolescents' self-perceptions and objective reports of problem gambling behaviors warrants further investigation.     

Epidemiological Associations between Gambling Behavior, Substance Use & Mood and Anxiety Disorders

Objective To compare gambling behaviors in a random sample of community residents with and without mental disorders identified by the Composite International Diagnostic Interview (CIDI).Method A large national community survey conducted by Statistics Canada included questions about problems arising from gambling activities as per the Canadian Problem Gambling Index (CPGI). We compared respondents within three gambling severity categories (non-problem, low severity and moderate/high severity gambling) across three diagnostic groupings (mood/anxiety disorders, substance dependence/harmful alcohol use, no selected psychiatric disorder).Results Of the 14,934 respondents age 18–64 years who engaged in at least one type of gambling activity in the previous 12 months, 5.8% fell in the low severity gambling category while 2.9% fell in the moderate/high severity category. Females accounted for 51.7% of the sample. The risk of moderate/high severity gambling was 1.7 times higher in persons with mood or anxiety disorder compared to persons with no selected disorder. For persons with substance dependence or harmful alcohol use, the risk of moderate/high severity gambling was 2.9 times higher. Persons with both mood/anxiety and substance/alcohol disorders were five times more likely to be moderate/high severity gamblers. The odds ratio for females was 0.6 and for those with less than post-secondary education it was 1.52. Differences in age and personal income were not significant.Conclusions Individuals in the community suffering from mood/anxiety disorders and substance dependence/harmful alcohol, and especially those with both, experience a higher risk for gambling problems. The treatment of these comorbidities should be integrated into any problem gambling treatment program.Disclaimer: The data upon which of the analyses contained in this paper derive from surveys conducted by Statistics Canada. The opinions expressed in this paper do not represent the opinions of Statistics Canada.     

Gambling and Problem Gambling Among Young Adolescents in Great Britain

International evidence suggests that problem gambling tends to be 2–4?times higher among adolescents as among adults and this proves to be true of Great Britain according to the latest adolescent prevalence survey. 8,958 British children (11–15) were surveyed in 201 schools during late 2008 and 2009. The questionnaire included a standard screen, DSM-IV-MR-J, to test for problem gambling. Our regression models explore influences of demographic, home and school characteristics on probabilities (both unconditional and conditional on being a gambler) of a child testing positive for problem gambling. More than 20% of children participated in gambling and, of these, nearly 8% tested positive. Age-group prevalence of problem gambling was 1.9%, compared with 0.6–0.9% in the most recent official adult surveys. Boys were much more likely than girls to gamble and to exhibit symptoms of problem gambling if they did. Generally, home characteristics, particularly parental attitude and example, dominated school characteristics in accounting for risks. Unanticipated findings included significantly elevated probabilities of problem gambling among Asian children and among children who live in a home without siblings. Child income was also a potent predictor of gambling and problem gambling.     

Gambling Related Cognitions Mediate the Association Between Thinking Style and Problem Gambling Severity

This study examined the associations among thinking style (rational versus experiential), gambling related cognitions, and problem gambling severity. The participants were 70 female and 41 male regular gamblers who completed the Gambling Related Cognitions Scale (Raylu and Oei, Addiction 99:757–769, 2004), the Rational-Experiential Inventory (Pacini and Epstien, J Pers Soc Psychol 76(6):972–987, 1999), and the Problem Gambling Severity Index (Ferris and Wynne, The Canadian problem and gambling index: final report. Canadian Centre on Substance Abuse, Ottawa, 2001). Rational thinking was negatively related to problem gambling severity. Gambling related biases increased with problem gambling severity but the strength of those biases was dampened by rational thought. The patterns by which gambling related cognition mediated the association between thinking style and gambling severity suggest that therapeutic interventions may benefit from a consideration of a gambler’s thinking style.     

Calorie Intake and Gambling: Is Fat and Sugar Consumption ‘Impulsive’?

Excessive calorie intake constitutes a global public health concern, due to its associated range of untoward outcomes. Gambling is commonplace and gambling disorder is now considered a behavioral addiction in DSM-5. The relationships between calorie intake, gambling, and other types of putatively addictive and impulsive behaviors have received virtually no research attention. Two-hundred twenty-five young adults who gamble were recruited from two Mid-Western university communities in the United States using media advertisements. Dietary intake over the preceding year was quantified using the Dietary Fat and Free Sugar Short questionnaire (DFS). Clinician rating scales, questionnaires, and cognitive tests germane to impulsivity were completed. Relationships between dietary fat/sugar intake and gambling behaviors, as well as other measures of psychopathology and cognition germane to addiction, were evaluated using correlational analyses controlling for multiple comparisons. Greater dietary fat and sugar intake were associated with lower educational levels and with male gender. Controlling for these variables, higher dietary fat and sugar intake were correlated significantly with worse gambling pathology and anxiety scores. Dietary sugar intake was also significantly associated with higher depressive scores, more alcohol intake, lower self-esteem, and with greater risk of having one or more mental disorders in general. Dietary intake did not correlate significantly with ADHD symptoms, presence of one or more impulse control disorders, Barratt impulsiveness, or cognitive functioning. These data suggest a particularly strong relationship between fat/sugar intake and symptoms of gambling pathology, but not most other forms of impulsivity and behavioral addiction (excepting alcohol intake). Providing education about healthy diet may be especially valuable in gamblers and in community settings where gambling advertisements feature prominently. Future work should explore the mediating mechanisms between calorie intake and gambling symptoms, such as whether this could be driven by environmental factors (e.g. advertising) or common dysfunction of brain reward pathways.     

Gambling Outcome Expectancies and Gambling Behavior Among African-American Adolescents: Gender as a Moderating Variable

Most high school adolescents have reported past year gambling, and males gamble more frequently and problematically than females. Ethnic minority adolescents appear to be gambling at a higher rate than Caucasian adolescents. There is evidence indicating that adolescent gambling outcome expectancies are correlated with gambling behavior, but limited evidence that this relation differs by gender. In the present study gender was evaluated as a moderator in the relation between gambling outcome expectancies and gambling behaviors in an African-American high school sample. Males gambled more frequently, gambled more problematically and held more positive gambling outcome expectancies than females. Gender was found to moderate the relations between gambling frequency and the expectations of material gain, affect, self-evaluation and parental approval. Gender also moderated the relations between gambling problems and expectations of affect and self-evaluation. These findings should inform future adolescent gambling prevention and intervention programs.     

Adolescent Gambling: Understanding the Role of Stress and Coping

The central variables of stress, coping, and gambling severity were examined along three lines of inquiry. The first addressed whether adolescents with gambling problems reported a greater number of minor or major stressful (i.e., negative) life events relative to others. The second examined whether more with gambling problems employed less-effective coping styles, such as those characterized as less task- or solution-focused, and more emotion- or avoidance-focused coping. Finally, the third question explored whether adolescents’ coping styles mediated the association between stress and gambling severity. Ranging from 11 to 20 years of age, 2,156 high-school students completed instruments assessing gambling involvement, gambling severity, stressful life events, and coping styles. Results indicated that, overall, adolescents with gambling-related problems reported more negative life events relative to social gamblers and non-gamblers. When negative life events were further separated into major and minor events, results revealed that problem gamblers reported more major negative life events but not more minor negative life events relative to others. Results indicated that adolescents with gambling-related problems used less task-focused coping, and more avoidance-focused coping. Males, but not females, who experience gambling-related problems reported using more emotion-focused coping strategies. Finally, emotion-oriented coping was found to mediate the relationship between negative life events and gambling severity. Implications and directions for future research are discussed.

Is Executive Cognitive Function Associated with Youth Gambling?

Our objectives for this report were to identify trajectories of youth gambling behavior, and to examine their relation to executive cognitive function (ECF) and associated problem behaviors. Philadelphia school children, enrolled at ages 10–12 years (n = 387; 49% male), completed three annual assessments of risk behaviors, ECF, impulsivity, problem behaviors and demographics. Across ages 10–15 years, using methods from Nagin et al., two groups were identified: Early Gamblers (n = 111) initiated early and continued in later assessments, and Later Gamblers (n = 276) initiated at later ages and gambled less. Betting money on cards and sports were the most frequently reported gambling behaviors. Using gambling group as outcome, final backward selection logistic regression model showed Early Gamblers are more likely male (P = 0.001), report more active coping (P = 0.042), impulsive behaviors (P ≤ 0.008), and have friends who gamble (P = 0.001). Groups were similar in ECF, parental monitoring, marital status, SES, and race. Early Gamblers had higher incidence of problem behaviors and drug use (all P ≤ 0.006). Two gambling groups were identified in early adolescence with Early Gamblers showing higher levels of impulsivity and comorbid problems but similar levels of ECF compared to Late Gamblers. As more gambling groups are identified through later adolescence, ECF may emerge as a relevant precursor of problem gambling at this later time.     

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.