Antisocial personality disorder and pathological gambling

The prevalence of antisocial personality disorder and its relationship to criminal offenses in pathological gamblers was investigated. A semi-structured interview schedule containing DSM-III criteria for antisocial personality and the California Psychological Inventory Socialisation subscale was administered to a sample of 306 pathological gamblers. Of the total sample, 35% reported no offense. Forty eight percent admitted to the commission of a gambling related offense, 6% to a non-gambling related offense, and 11% to both types of offense. Fifteen percent of subjects met DSM-III diagnostic criteria for antisocial personality disorder. Though these subjects were at greatest risk for committing criminal offenses, offenses were committed independently of DSM-III antisocial personality disorder in the majority of gamblers. It was concluded that features of antisocial personality emerged in response to repeated attempts to conceal excessive gambling and gambling induced financial difficulties.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.     

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.     

An Examination of the Relationship Between Gambling and Antisocial Behavior

Problem gambling is significantly more prevalent in forensic populations than in the general population. Although some previous work suggests that gambling and antisocial behavior are related, the extent and nature of this relationship is unclear. Both gambling and antisocial behavior are forms of risk-taking, and may therefore share common determinants. We investigated whether individual differences in personality traits associated with risk-taking, the Big Five personality traits, and antisocial tendencies predicted gambling and antisocial behavior among 180 male students recruited for a study of gambling (35.0% non-problem gamblers, 36.7% low-risk gamblers, 21.7% problem gamblers, and 6.7% pathological gamblers). All forms of gambling and antisocial behavior were significantly correlated. Personality traits associated with risk-acceptance explained a significant portion of the variance in problem gambling, general gambling involvement, and all forms of antisocial behavior. Antisocial tendencies (aggression and psychopathic tendencies) explained a significant portion of additional variance in severe antisocial behavior but not moderate or minor antisocial behavior. When controlling for personality traits associated with risk-acceptance, the relationship between gambling and antisocial behavior was greatly diminished. The results are consistent with the hypothesis that gambling and antisocial behavior are associated because they are, in part, different manifestations of similar personality traits.     

The factorial structure of pathological gambling

Pathological gambling has been characterised by DSM-III-R and DSM-IV as a disorder of impulse control with a proportion of gamblers identified as meeting criteria for a co-morbid diagnosis of Antisocial Personality Disorder. To date, empirical evidence in support of the notion that pathological gamblers as a group manifest elevated traits of impulsivity remains equivocal. Principal components analysis was used to investigate relationships between the constructs of impulsivity, psychopathy, DSM-III-R criteria for Antisocial Personality Disorder, psychological distress, criminal offending behavior and a range of other common psychological measures employed with pathological gamblers. The sample comprised 115 pathological gamblers, 80 consecutive gamblers seeking treatment from a general hospital psychiatric inpatient behavior therapy unit, and 35 volunteer Gamblers Anonymous attenders. Four primary factors were determined: psychological distress, sensation seeking, crime and liveliness, and impulsive-antisocial. Results suggest that pathological gambling consists of a number of discrete and reproducible factorial structures. The impulsive antisocial factor was found to be associated with gambling behavior and indices of poor psychosocial functioning.     

Prevalence of pathological gambling and associated problems in individuals who visit non-gambling video arcades

The objective of the present study was to investigate the gambling behavior of individuals who frequent non-gambling video games arcades. One hundred and twenty two subjects (mean age of 19.2 years (SD=5.5); males constituted 82.8%) who spend time in arcades completed the South Oaks Gambling Screen and the Jacob's Health Survey. The results showed that 10.7% were identified as probable pathological gamblers and 14.8% were problem gamblers. The frequency of visits to arcades for non-gambling activities appeared to be correlated with the extent to which individuals gamble, and is furthermore associated with pathological gambling. The rate of pathological gamblers who frequent arcades is more than twice as high as the rates reported in other studies with adolescents and adults.This research was partially supported by grants from the Fonds Richelieu and Loto-Québec awarded to the first author.     

Social,psychological and physical consequences of pathological gambling in Sweden

Social, psychological and physical consequences of pathological gambling reported by 42 pathological gamblers recruited mainly by advertising were compared with data on 63 pathological gamblers identified by case-finding within districts of probation, in- and out-patient psychiatric care and social welfare authorities. The two studies gave similar results. Financial breakdown, impaired relations with family and friends, and psychological problems occurred in about 50% of the pathological gamblers. Physical consequences were perceived to be of minor significance. Gambling became a solitary behavior as illegal behaviors to finance gambling increased. The pathological gamblers frequently abused alcohol. Despite these signs of social decay the pathological gamblers strove not to be a burden in society.     

Updates of the Prevalence of Problem Gambling in Romanian Teenagers

The aim of this study was to find out what is the prevalence of pathological in Romanian teenagers. We questioned one thousand thirty-two teenagers in Cluj-Napoca and Harghita counties. Participants completed a questionnaire with 40 items including gamblers anonymous twenty questions. The sample included teenagers aged 11–19 years; 65.57% were male and 34.43% were female. The subjects were divided into three groups: non-gambling/recreational gambling or occasional gambling (0–1 positive answers —Level 1)—753 subjects (72.96%) [316 females and 437 males]; problem gambling (2–6 points—Level 2)—243 subjects (23.54%) [43 females and 200 males]; pathological gambling (above 7 points—Level 3)—36 subjects (3.48%) [3 females and 33 males]. The mean age of pathological gamblers was 16.48 years. Gender differences were as expected, males engaging in pathological gambling (91.66% from pathological gamblers) more than females did (8.33% from pathological gamblers). Data revealed that the most encountered games practiced weekly were sport bets and slot machines in the case of 36.11% of the pathological gamblers; lotto, internet casino and pool bets each with 25%, followed by roulette and black-jack with 22.22%.From those who reported practicing gambling at a pathological level 66.66% engaged in alcohol consumption, 13.88% illicit drug use and 19.44% licit drugs. Just 16.66% smoke cigarettes. Data revealed higher rates of prevalence in Romanian teenagers than in other Central and Eastern European countries. A prevalence study at a national level should be designed.     

Altering the DSM-III criteria for pathological gambling

Following a critique and revision of the diagnostic criteria for pathological gambling in DSM-III, a field trial of the revised criteria was conducted. Four groups of individuals (762 in all) were surveyed: Gamblers Anonymous members, college students, hospital employees, and outpatients in treatment for pathological gambling. The revised criteria were found to discriminate effectively between pathological gamblers and others. In order to refine the cutoff point, the results on the DSM-III revision were compared to the South Oaks Gambling Screen, a valid, reliable instrument for screening pathological gamblers (Lesieur & Blume, 1987). A cutoff point of four or more items was found to be optimal in diagnosing pathological gamblers.This research was funded by the South Oaks Foundation, Amityville, New York. Special thanks are given Sheila Blume, M.D., Julian I. Taber, Ph.D. and Robert L. Custer, M.D. for their comments on earlier drafts of this paper.     

Impaired Metacognitive Capacities in Individuals with Problem Gambling

Impaired insight into behavior may be one of the clinical characteristics of pathological gambling. In the present study, we tested whether the capacity to evaluate accurately the quality of one’s own decisions during a non-gambling task was impaired in problem gamblers. Twenty-five problem gamblers and 25 matched healthy participants performed an artificial grammar-learning paradigm, in which the quality of choice remains uncertain throughout the task. After each trial of this task, participants had to indicate how confident they were in the grammaticality judgements using a scale ranging from 1 (low confidence) to 7 (high confidence). Results showed that (i), problem gamblers’ performance on the grammaticality test was lower than controls’; (ii) there was a significant correlation between grammaticality judgments and confidence for control participants, which indicates metacognitive insight and the presence of conscious knowledge; (iii) this correlation was not significant in problem gamblers, which suggests a disconnection between performance and confidence in this group. These findings suggest that problem gamblers are impaired in their metacognitive abilities on a non-gambling task, which suggests that compulsive gambling is associated with poor insight as a general factor. Clinical interventions tailored to improve metacognition in gambling could be a fruitful avenue of research in order to prevent pathological gambling.     

Numerical Reasoning Ability and Irrational Beliefs in Problem Gambling

Numerous studies have shown that pathological gamblers are particularly prone to various cognitive biases that may explain why they continue to gamble despite having occurred substantial losses. A common explanation advanced to account for this finding is that pathological gamblers may have poorer numerical or statistical knowledge than other people. Addressing these deficits is therefore seen as one possible way in which to assist pathological gamblers or prevent the development of problematic behaviour within the broader community. The aim of this study was test this assumption by assessing the numerical reasoning skills, objective gambling knowledge and tendency towards biased reasoning in a sample of 90 regular poker-machine gamblers (pathological and non-pathological) and a non-gambling comparison group (n = 45). Analyses based on both group comparisons and regression analyses controlling for differences in educational attainment showed that pathological gamblers scored significantly higher on the cognitive biases measure than other gamblers. However, this difference could not be attributed to poorer knowledge of gambling odds or limited numerical ability among pathological gamblers. The findings suggest that educating pathological gamblers with greater knowledge about the odds of gambling is unlikely to be an effective harm minimisation strategy.     

Gambling Participation and Problems Among Employees at a University Health Center

This study evaluated the frequency and intensity of gambling behaviors among employees at an academic health center. Employees were sent an anonymous questionnaire assessing demographic characteristics, participation in gambling activities, and gambling-related problems. Of the 904 respondents, 96% reported gambling in their lifetimes, with 69% gambling in the past year, 40% in the past two months, and 21% in the past week. The most common forms of gambling were lottery and scratch tickets, slot machines, card playing, sports betting, bingo, and track. Only 1.2% of the sample reported gambling on the internet. Using scores on the South Oaks Gambling Screen, 3.0% of the respondents were classified as Level 2 (or problem) gamblers, and an additional 1.8% were Level 3 (or pathological) gamblers. Compared to Level 1 (non-problem) gamblers, Level 2 and Level 3 gamblers were more likely to be male, single, and employed full-time, and to have lower income and education. About half of the Level 2 and Level 3 gamblers reported interest in an evaluation of their gambling behaviors and treatment interventions. These data suggest the need to screen for gambling problems in health care professionals and to provide gambling-specific treatments.     

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.     

A Preliminary Investigation of Abstinence and Controlled Gambling as Self-Selected Goals of Treatment for Female Pathological Gambling

The current study aimed to provide a preliminary evaluation of the differential efficacy of a cognitive-behavioural treatment program for female pathological gamblers delivered with the goals of abstinence or controlled gambling. The findings were based on the comparison of pathological gamblers selecting abstinence and pathological gamblers selecting controlled gambling on measures of gambling behaviour and psychological functioning. The findings revealed that pathological gamblers selecting controlled gambling displayed comparable levels of improvement to those displayed by gamblers selecting abstinence. Using a treatment completer approach, 89% of the gamblers selecting abstinence compared with 82% selecting controlled gambling no longer satisfied the diagnostic criteria for pathological gambling by the completion of the 6-month follow-up period. Although further scientific demonstration is required, the findings of this study provide preliminary support for the practice of offering controlled gambling as an alternative goal in the treatment of pathological gambling.     

Gambling and Problem Gambling Among Recently Sentenced Women in New Zealand Prisons

Ninety-four recently sentenced women prisoners were interviewed to assess aspects of their gambling involvement, problem gambling and relationships between gambling and criminal offending. A third of the women, on the basis of their SOGS-R scores, were assessed as lifetime probable pathological gamblers and just under a quarter were assessed as probable pathological gamblers during the 6 months prior to imprisonment. For women prisoners, a preference for non-casino gaming machines and housie were predictive of problem gambling. Relative to non-problem gamblers, problem gamblers experienced higher rates of childhood conduct disorder and current non-psychotic mental disorder. Just over a quarter of prisoners and a half of the problem gamblers had committed a crime to obtain money to gamble. Few women said their early offending or convictions related to gambling. It was concluded that most women were “criminals first and problem gamblers second” rather than people whose offending careers commenced as a consequence of problem gambling. However, the extent of problem gambling-related offending among the women prisoners highlights the potential for comprehensive assessment and treatment programs in prison to reduce recidivism and other adverse impacts of problem gambling and gambling-related offending.     

Potential and probable pathological gamblers: Where do the differences lie?

A large proportion of adolescents engage in gambling activities and the prevalence of pathological gambling is high. This study presents a factor analysis of responses from 122 college students who obtained a score of 3 or greater on the South Oaks Gambling Screen (SOGS), the most widely used instrument to identify probable and potential pathological gamblers. The analysis showed five dimensions: Illegal Behaviors, Heavy Gambling, Eating Disorders, Parentally Modelled/Less Impulsive, and Worry. Analyses revealed that except for the Eating Disorders factor, all factors clearly differentiated the probable from potential pathological gamblers, as identified by the SOGS. Results raise important questions about the relationship of pathological gambling to other psychopathological or antisocial behaviors. Thus the probable pathological gambler category represents a wide-ranging behavioral profile that goes beyond gambling per se. Avenues for future research as well as clinical implications are discussed.This research was partially supported by grants from Le Fonds Richelieu, le Conseil Québécois de la Recherche Sociale and the Social Sciences and Humanities Research Council of Canada.     

Examining DSM-IV Criteria for Pathological Gambling: Psychometric Properties and Evidence from Cognitive Biases

We examined the DSM-IV criteria for pathological gambling as assessed with the DSM-IV-based Diagnostic Interview for Gambling Severity (DIGS; Winters, Specker, & Stinchfield, 2002). We first analyzed the psychometric properties of the DIGS, and then assessed the extent to which performance on two judgment and decision-making tasks, the Georgia Gambling Task (Goodie, 2003) and the Iowa Gambling Task (Bechara, Damasio, Damasio, & Anderson, 1994), related to higher reports of gambling pathology. In a sample of frequent gamblers, we found strong psychometric support for the DSM-IV conception of pathological gambling as measured by the DIGS, predictive relationships between DIGS scores and all cognitive performance measures, and significant differences in performance measures between individuals with and without pathological gambling. Analyses using suggested revisions to the pathological gambling threshold (Stinchfield, 2003) revealed that individuals meeting four of the DSM-IV criteria aligned significantly more with pathological gamblers than with non-pathological gamblers, supporting the suggested change in the cutoff score from five to four symptoms. Discussion focuses on the validity of the DSM-IV criteria as assessed by the DIGS and the role of cognitive biases in pathological gambling.     

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.     

Adolescent females who have sexually offended: comparisons with delinquent adolescent female offenders and adolescent males who sexually offend

Very little is known about adolescent females who commit sexual offenses. In this two-part exploratory study, a sample of 11 adolescent females with sexual offense histories is described. In Study I, the sample is compared to an age-matched sample of 11 adolescent females with non-sexual victim-involved offense histories. The sexually offending group had significantly fewer antisocial behavior problems, such as alcohol or drug use problems, problems with fighting, or problems at school. They began their offense behaviors at younger ages than their non-sex offending delinquent peers. Few differences emerged with respect to attitudes about offense behaviors, such as level of denial. In Study II, the same sample of females with sex offense histories was compared with a group of age-matched adolescent males with sex offense histories. The two sex-offending groups were found to be remarkably similar. There were few differences with respect to psychosocial and criminal histories, antisocial behavior, and variables related to clinical presentation and treatment (e.g., level of denial about offense). Likewise, the two groups are remarkably similar with respect to specific sex offense behaviors. The females, however, appear to have experienced more severe and pervasive abuse compared to the males.     

Plasma endorphin levels in pathological gambling

Despite its formal definition as a disorder of impulse control, pathological gambling has come under the generic label of addictive disorders with subjective excitement and physiological arousal as the major motivating factor. Individual differences in autonomic/cortical arousability in interaction with irregular schedules of reinforcement have been postulated to be important determinant factors in the pathogenesis of pathological gambling (Anderson & Brown, 1984). Mood disturbances and cross-addictions are frequently observed in pathological gamblers seeking treatment and the behavior has also been conceptualized as a defense against depression and anxiety. Recently the role of endorphins has been implicated in mood disturbances associated with psychiatric states and in addictive processes; the latter through their euphorogenic or reward-transmitting properties in accordance with operant and classical conditioning principles. The hypothesis that the etiology or maintenance of gambling behavior is related to endorphin activity was investigated in this study. Using radioimmunoassay techniques, baseline B-endorphin plasma levels were measured in a sample of 39 pathological gamblers seeking treatment and 16 male and 19 female non-gambling healthy control subjects. In addition, B-endorphin reactivity to gambling activity was measured in a subgroup of 13 horse-race gamblers.Diagnostic and Statistical Manual III criteria for diagnosis were used. Written consent was obtained. Blood samples were drawn at the same time of day for each subject. The experimental procedure consisted of taking baseline blood samples at 11 a.m. following which subjects were instructed to place a bet sufficient to excite them on a horse-race. A subsequent blood sample was taken at 2 p.m., five minutes after subjects listened to the race broadcast on radio. Heart rate measures and a visual analogue scale rating excitement, tension and urge to gamble were also administered immediately before and after the race broadcast. Results showed that as a group pathological gamblers did not differ from controls on baseline B-endorphin levels. But differentiating gamblers according to type of gambling activity revealed horserace addicts to have significantly lower baseline levels as compared to poker-machine players and controls. This finding provides empirical evidence for the hypothesis that distinct subgroups of gamblers exist and raises the corollary that different etiological factors may characterize each subgroup. That B-endorphin levels did not increase in response to gambling was explained by the failure of the relatively small bet size to generate high arousal.This paper was presented at the Sixth National Conference on Gambling and Risk Taking, held at Atlantic City, New Jersey, December 9 to 12, 1984.     

Internet Gamblers Differ on Social Variables: A Latent Class Analysis

Online gambling has gained popularity in the last decade, leading to an important shift in how consumers engage in gambling and in the factors related to problem gambling and prevention. Indebtedness and loneliness have previously been associated with problem gambling. The current study aimed to characterize online gamblers in relation to indebtedness, loneliness, and several in-game social behaviors. The data set was obtained from 584 Internet gamblers recruited online through gambling websites and forums. Of these gamblers, 372 participants completed all study assessments and were included in the analyses. Questionnaires included those on sociodemographics and social variables (indebtedness, loneliness, in-game social behaviors), as well as the Gambling Motives Questionnaire, Gambling Related Cognitions Scale, Internet Addiction Test, Problem Gambling Severity Index, Short Depression–Happiness Scale, and UPPS-P Impulsive Behavior Scale. Social variables were explored with a latent class model. The clusters obtained were compared for psychological measures and three clusters were found: lonely indebted gamblers (cluster 1: 6.5%), not lonely not indebted gamblers (cluster 2: 75.4%), and not lonely indebted gamblers (cluster 3: 18%). Participants in clusters 1 and 3 (particularly in cluster 1) were at higher risk of problem gambling than were those in cluster 2. The three groups differed on most assessed variables, including the Problem Gambling Severity Index, the Short Depression–Happiness Scale, and the UPPS-P subscales (except the sensation seeking subscore). Results highlight significant between-group differences, suggesting that Internet gamblers are not a homogeneous group. Specific intervention strategies could be implemented for groups at risk.