Adolescents with Gambling Problems: From Research to Treatment

Considerable interest in the area of youth gambling has prompted an increase in empirical investigations examining the correlates associated with youth experiencing severe gambling problems. Based upon the current state of knowledge and our clinical experience, the development of the treatment program for youth with serious gambling problems employed at the McGill University Youth Gambling Research and Treatment Clinic is described. The major tenets, underlying philosophy, and therapeutic processes are presented. A case study is included to illustrate the therapeutic approach. The authors present the need for greater funding for more basic and applied research and the necessity for further scientifically validated treatment and prevention programs.     

Characteristics of Gambling Helpline Callers with Self-Reported Gambling and Alcohol Use Problems

The characteristics of problem gamblers calling the Connecticut Council on Problem Gambling (CCPG) gambling helpline during the years 2000–2001 (n = 960) were examined based on the presence or absence of self-reported alcohol use problems. A relatively low proportion of callers reported a problem with alcohol use (173/960 or 18.0%), and of those acknowledging an alcohol use problem, the majority reported a past rather than current problem (143/173 or 82.7%). A logistic regression analysis found that, as compared with problem gamblers denying any alcohol use problems, those reporting past or current alcohol use problems were more likely to be male and more frequently acknowledged problems with more forms of gambling, suicide attempts related to gambling, arrests secondary to gambling, daily tobacco use, drug use problems, prior substance abuse treatment, and family histories positive for alcohol and drug use problems. The findings highlight the strong relationship between alcohol use problems and other substance use problems, and suggest that problem gamblers with as compared with those without alcohol use problems demonstrate greater problems in multiple areas (arrest, attempted suicide) linked by impaired impulse control.Please address correspondence to Marc N. Potenza, Director, Problem Gambling Clinic; Director, Women and Addictive Disorders Core, Women’s Health Research at Yale; Yale University School of Medicine, Connecticut Mental Health Center, Room S-104, 34 Park Street, New Haven, CT 06519. E-mail: marc.potenza@yale.edu.     

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.     

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.”     

Comparing the New Zealand and Swedish National Surveys of Gambling and Problem Gambling

National surveys of gambling and problem gambling have recently been completed in New Zealand and Sweden. These studies are unique in that data collection was undertaken by official government statistical agencies, involved large, nationally representative samples, and attained high response rates. Comparison of the findings is facilitated by the use of similar procedures and instrumentation and is of interest in that both countries have similar per capita gambling expenditure and welfare states that have recently undergone major economic and social restructuring. Data on gambling participation, problem gambling prevalence and risk factors for problem gambling are presented and discussed. While there are a number of similarities and differences, the Swedish findings are more similar to those of an earlier national survey conducted in New Zealand during 1991. This suggests that risk factors are changing over time in relation to evolving patterns of gambling participation and attitudes towards gambling, a finding that has implications for future patterns of gambling and problem gambling in these and other countries.     

Profiling Lady Luck: An Empirical Study of Gambling and Problem Gambling Amongst Female Club Members

This paper helps to address a deficiency of gender-specific research into gambling. It focuses on gambling participation, gaming machine play, and problem gambling amongst 1,257 female respondents to a telephone survey of 3,000 members selected randomly from the membership lists of six of the largest clubs in Sydney, Australia. Using predominantly non-parametric tests, results identify a range of behaviors that characterize the gambling activities of female club members when compared to their male counterparts. Testing four hypotheses revealed that, when compared to male club members, the females had a higher preference for bingo, lotto, lotteries, pools, and gaming machines; they gambled less frequently on off-course and on-course betting, casino table games and hotel gaming machines, but more frequently on bingo; they were more likely to display patterns of gaming machine play that maximize playing time; and they experienced problem gambling at levels comparable to males. Further research questions arising from the study's findings are discussed.     

Gambling attitudes and beliefs associated with problem gambling: the cohort effect of Baby Boomers

Recreational and problem gamblers alike hold beliefs about gambling that are dysfunctional. These dysfunctional beliefs have been theorized to play a role in problem gambling behaviour. The current study sought to examine the effects of gambling attitudes and beliefs on problem gambling behaviour across three cohorts. A sample of 308 participants consisted of 101 individuals from Generation X, 139 from the Baby Boom cohort and 68 from the Silent Generation. Hierarchical multiple regressions showed that for Baby Boomers, higher scores on scales measuring beliefs about luck and illusions of control were associated with higher scores on measures of problem gambling than for the Silent Generation. Generation X’s higher scores on luck scales were associated with higher scores in problem gambling than the Baby Boom cohort. Attitudes associated with problem gambling did not differ among cohorts. These results suggest that while cohorts may not differ in types or levels of distorted beliefs, they differ in how such distortions relate to problem gambling. Future research should focus on determining whether such cohort effects are indicative of differences within the development and maintenance of problem gambling itself.     

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.     

Behavior Genetic Research on Gambling and Problem Gambling: A Preliminary Meta-Analysis of Available Data

A meta-analysis of family and twin studies on gambling and problem gambling was initiated in an effort to determine the probable role of genetic factors in high risk wagering. Two twin studies and 17 investigations employing the family history or family study method were included in this meta-analysis. A summation of the 19 studies produced a small but significant overall effect size (weighted = .10, unweighted = .13), with both family (weighted = .12, unweighted = .14) and twin (weighted = .06, unweighted = .05) studies achieving significant individual mean effects. Given the paucity of twin data, further analysis was confined to family studies and revealed a stronger familial effect for the sons of problem gambling fathers than for the daughters of problem gambling mothers and for more severe forms of problem gambling than for less severe forms of problem wagering, and was strongest for high severity problem gambling in males. The implications of these results are discussed.     

Superstitious Beliefs in Gambling Among Problem and Non-Problem Gamblers: Preliminary Data

Superstitious beliefs, defined as a strong conviction based on the erroneous perception of a cause-effect association between two independent events, are considered to play an instrumental role in the maintenance of gambling behaviour. In this preliminary study, responses to eight items assessing superstitious beliefs were compared among 56 electronic gaming machine (EGM) problem gamblers, 22 non-problem EGM and 23 non-EGM non-problem gamblers. Results suggested that problem gamblers endorsed more superstitious beliefs than non-problem gamblers and that such beliefs were correlated with gambling intensity. Further research is required to determine if superstitious beliefs represent a vulnerability factor for the development of problem gambling or emerge as a consequence of involvement in gambling.     

A Perspective on Problem Gambling Treatment: Issues and Challenges

Researchers face several challenges in conducting gambling treatment research. These include the impact of monetary incentives to participate, difficulty in subject recruitment, treatment ambivalence, heterogeneity of gambling behaviors among treatment samples, the role of natural recovery, the impact of intractable financial pressures, and the specification of adequate process and outcome measures. Each challenge is defined and potential resolutions suggested.     

The Stubborn Logic of Regular Gamblers: Obstacles and Dilemmas in Cognitive Gambling Research

Cognitive studies into gambling behaviour have shown that many gamblers misinterpret the odds of gambling activities, hold false beliefs about skill and luck, and over-estimate their subjective chances of success. Accordingly, providing accurate information about gambling in venues, or on slot-machines, would appear to be a sensible way to enhance the 'safety' of gambling products. Unfortunately, such ideas for educating gamblers may be difficult to implement in practice because of limitations and conceptual dilemmas in the cognitive literature. Irrational beliefs about gambling may be difficult to falsify, are often highly idiosyncratic and context-bound, and may stem more from the selective misuse of information than from a lack of knowledge about gambling activities. Drawing evidence from recent research into gambling-related cognitions, this paper examines the key elements of irrational-belief systems, and how this work might usefully inform the design of future consumer information initiatives.     

Juvenile Gambling in North America: An Analysis of Long Term Trends and Future Prospects

Long term trends, based on findings from twenty independent prevalence studies surveying middle and high school youth in North America, suggest that within the past year two out of three legally underage youth have gambled for money. In the United States and Canada as many as 15.3 million 12–17 year olds have been gambling with or without adult awareness or approval, and 2.2 million of these are experiencing serious gambling-related problems. Lottery play dominates legalized forms of gambling among juveniles in both the United States and Canada. Trends between 1984–1999 indicate a substantial increase in the proportion of juveniles who report gambling within the past year, and a parallel increase in the proportion of juveniles reporting serious gambling-related problems. Yet, there continues to be little public awareness or concern about the extent, or the potential hazards associated with juvenile gambling. A composite profile of juveniles reporting numerous gambling problems is contrasted with their peers who reported few or none. Future prospects concerning this growing problem are offered.     

Treatment Goal Selection for Female Pathological Gambling: A Comparison of Abstinence and Controlled Gambling

The current study was an exploratory investigation of the selection of controlled gambling as a goal of treatment for female pathological gambling. Specifically, it aimed to explore: 1) the popularity of controlled gambling as a goal of treatment; 2) the reasons pathological gamblers select abstinence and controlled gambling as goals of treatment; and 3) the characteristics of pathological gamblers attracted to abstinence and controlled gambling. The sample comprised 85 female pathological gamblers attending a cognitive-behavioural treatment program for pathological gambling. The selection of controlled gambling by one-third (34%) of the sample suggests that, at least in the Australian context, controlled gambling is a relatively popular goal of treatment for female pathological gamblers. In this study, the only differences between treatment-seeking female pathological gamblers selecting abstinence and controlled gambling were that those selecting controlled gambling were older and were less likely to endorse the belief that problematic gambling is a disease or affliction that can only be overcome by lifelong abstinence. Further research investigating the characteristics of pathological gamblers associated with controlled gambling as both a goal and outcome of treatment is required in order to ensure that treatment-seeking pathological gamblers can make an informed decision regarding their goal selection.     

The Security of Gambling and Gambling with Security: Hacking,Law Enforcement and Public Policy*

This paper studies the relationship between criminal organization and social control in the area of computer crime. We examine a ‘cheat at play’ scheme that hacked into electronic gambling machines. We focus on how these cyber-attacks were committed and on the ability of the state and the industry to control them. We compare and contrast our findings with the research on hacking and the gambling industry and conclude by discussing the implications that our research has for law enforcement, security and consumer protection.     

The Security of Gambling and Gambling with Security: A Rejoinder

Social media has become an established tool to engage and maintain customer loyalty. However, its successful use involves a balance between promotion, public relations and corporate social responsibility. Nineteen individuals working in the Australian gambling industry were interviewed. The aim was to explore how gambling operators are using social media to engage with users and promote products, their considerations underpinning these actions, and the extent to which responsible gambling practices are included. All operators were active on social media and used these platforms to attempt to increase customer engagement and strengthen existing relationships. Gambling-related content was usually balanced against non-gambling content, or operators focused exclusively on non-gambling content. Sales goals or raising revenue were not direct aims of social media use. Operators sought to use social media as an indirect way to maintain their customer base and attract new customers via favourable ratings and information transfer. Few operators provided specific responsible gambling messages, despite being mindful of the dangers of targeting vulnerable populations, specifically young people and problem gamblers. This study is unique as it provides an in-depth first-hand account of how gambling operators are using social media.     

Adaptation and validation of the Gambling Motives Questionnaire-Financial (GMQ-F) in a sample of French-speaking gamblers

Previous research has identified specific gambling motives and linked them with both healthy and disordered gambling. The Gambling Motives Questionnaire (GMQ) is currently the most widely used measure for these motives. The present study aimed to offer a French validation of the latest version of this scale, the GMQ-Financial (GMQ-F), which measures four distinct motives (enhancement, social, coping, financial). The French GMQ-F was completed by 278 gamblers from the community and 22 treatment-seeking pathological gamblers, along with scales assessing gambling cognitions, impulsivity, disordered gambling symptoms and psychopathological symptoms. Confirmatory factor analysis supported the expected four-factor model. The GMQ-F subscales have good internal reliability. Validity of the GMQ-F is supported by specific correlations with the other constructs measured. Pathological gamblers differed from gamblers from the community on all but one (social) of the GMQ-F subscales. The French GMQ-F presents good psychometric properties and constitutes a reliable instrument for measuring gambling motives in research and clinical practice.     

Adverse Childhood Experiences and Gambling: Results From a National Survey

Pathological gambling disorder and problem gambling are addictive disorders with severe consequences for individuals, families, and society. Knowledge about associations between childhood adverse experiences (i.e., physical, sexual, and emotional abuse) and gambling pathology in adulthood is limited. Using data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), associations between adverse childhood experiences and lifetime gambling status were tested. Strong bivariate associations between adverse childhood experiences and gambling status were found, which were attenuated with the inclusion of clinical covariates. Adverse childhood experiences might be related to pathological gambling in adulthood, but this relationship might not be gambling-specific.     

Not the Same: A Comparison of Female and Male Clients Seeking Treatment from Problem Gambling Counselling Services

Previous studies of problem gamblers portray this group as being almost exclusively male. However, this study demonstrates that females comprised 46% of the population ( n = 1,520) of persons who sought assistance due to concerns about their gambling from the publicly-funded BreakEven counselling services in the state of Victoria, Australia, in one 12-month period. This suggests that the model of service delivery which is community based counselling on a non-residential basis may be better able to attract female clients than treatment centres where males predominate such as veterans centres. A comparative analysis of the social and demographic characteristics of female and male gamblers within the study population was undertaken. As with previous studies, we have found significant differences between males and females who have sought help for problems associated with their gambling. Gender differences revealed in this study include females being far more likely to use electronic gaming machines (91.1% vs. 61.4%), older (39.6 years vs. 36.1 years), more likely to be born in Australia (79.4% vs. 74.7%), to be married (42.8% vs. 30.2%), living with family (78.9% vs. 61.5%) and to have dependent children (48.4% vs. 35.7%), than males who present at these services. Female gamblers (A$7,342) reported average gambling debts of less than half of that owed by males (A$19,091). These gender differences have implications for the development and conduct of problem gambling counselling services as it cannot be assumed that models of service which have demonstrated effectiveness with males will be similarly effective with females.     

Problem Gambling and its Impact on Families: A Literature Review

This paper offers an overview of the existing literature concerning problem gambling and families and identifies gaps in current research knowledge on this topic. Relevant theoretical perspectives are outlined and the role of familial factors in the development of problem gambling is discussed. This is followed by a focused review of the effects of problem gambling on family members, specifically the spouse, children and parents. Available treatments and therapies for family members are also reviewed. The paper concludes by identifying the limitations of existing knowledge and some directions for future research on this topic.