The gambling lifestyle: I. theory

This paper describes the lifestyle model of gambling behavior in which compulsive gambling behavior is conceptualized as a lifestyle characterized by pseudoresponsibility, self-ascension, hypercompetitiveness, and social rule breaking/bending/ twisting. The underlying premise of this theory is that gambling behavior takes on the appearance of a lifestyle when it is viewed by the individual as a viable means of enhancing self-worth, minimizing personal insecurity, and controlling fear. Three primary areas of theoretical and research interest are covered in this paper: (1) the theoretical underpinnings of lifestyle theory; (2) the individual components (conditions, choice, cognition) of a gambling lifestyle; and (3) the developmental progression of a gambling lifestyle.The author would like to thank Henry Lesieur and anonymous reviewers of earlier versions of this paper for their helpful comments. The assertions and opinions contained herein are the private views of the author and should not be construed as official or as reflecting the views of the Federal Bureau of Prisons or United States Department of Justice.     

Editorial comment

The special issue of theJournal of Gambling Behavior, dedicated to a discussion of compulsive gambling and the law, represents a first effort in addressing some of the many complicated issues on this topic. Articles by experts on compulsive gambling—written by legal authorities, a treatment provider, and victims of the disorder—are included to present the broadest possible forum to analyze the turmoil the idea of compulsive gambling is having on the American legal system. Included are an historical account of how changing laws affect compulsive gamblers, problems facing the expert witness, effects of civil service policies and military law, comparisons of U.S. and English legalization debates, lottery issues, concerns of a lawyer representing casinos, and personal accounts by those who are suffering from this disorder.I. Nelson Rose is an Associate Professor of Law at Whittier College School of Law as well as a licensed attorney. Professor Rose is recognized as the nation's leading authority on gambling and the law.Dr. Valerie C. Lorenz has specialized in research, education and treatment of compulsive gamblers since 1973. She has extensive experience in military, state and federal courts, having served as a qualified expert witness on compulsive gambling.     

Recommendations for research and public policy in gambling studies

The purpose of this article is to respond to and expand on the ideas presented by Father McGowan in The Ethics of Gambling Research: An Agenda for Mature Analysis. We provide specific recommendations for future research and public policy in the field of gambling studies. We suggest that key conceptual definitions—such as, problem, compulsive, and pathological gambling—should be clarified, established, and distinguished from one another before gambling research is conducted. Proper methodological procedures are recommended, where power analyses, pilot studies, and representative samples are appropriately conducted and analyzed. Retrospective and Prospective studies are considered and differentiated while Discrete Time Event History Analysis—namely, Life Tables Analysis and Discrete Time Logistic Regression—are proposed.     

On a Roll: The Process of Initiation and Cessation of Problem Gambling Among Adolescents

As gambling becomes more accessible and acceptable in society, problems associated with gambling and gaming have begun to affect ever increasing numbers of adolescents. Although restricted from most forms of gambling by law, many adolescents are finding a path into problem gambling. Some are becoming compulsive gamblers early in their gambling career, facing a future filled with consequences and problems. Understanding the pathway or process by which these adolescents become engaged in gambling behavior and how they can extricate themselves from this addictive behavior can enhance the efficiency and effectiveness of our interventions. This article offers a perspective on the initiation and cessation of compulsive gambling using the basic elements of the process of intentional behavior change outlined in the Stages of Change from the Transtheoretical Model. The process of initiation of a problematic behavior is similar to the process of modification or cessation of a problematic behavior in terms of these stages of change. With adolescents it is important to distinguish between the process of initiation, which has implications for prevention of gambling problems, and the process of cessation, which often necessitates the assistance of treatment. Creating interventions that parallel the process of change offers the potential for personalizing and potentiating efforts to reduce the prevalence and consequences associated with compulsive or pathological and problem gambling. Application of this model to gambling behavior offers a heuristic that is intriguing and requires substantiation through rigorous research.     

On being the expert witness for the compulsive gambler facing legal charges

Compulsive gambling is a psychiatric disorder — an addiction to gambling in which the substance abused is money. When legal access to money is no longer available, compulsive gamblers will often resort to illegal activities in order to obtain funds with which to support their addiction.Attorneys and judges typically have only minimal training in understanding mental disorders. Few can distinguish between types of gamblers or types of mental disorders. Most often they are unaware of treatment options. Thus the role of the expert witness in compulsive gambling cases becomes multidimensional. The expert witness must not only diagnose the defendant, but often finds it necessary to educate the attorneys, probation officer and judge involved in a criminal action. In order to best serve the client, the expert witness must have a wide range of knowledge and experience: the expert witness must be able to evaluate the defendant, must know the illness, understand the legal and judicial systems, be aware of attitudes of the community, consider options within the correctional system, and know treatment alternatives.Dr. Lorenz is the Director of the Forensic Center for Compulsive Gambling, located at 651 Washington Boulevard, Baltimore, Maryland, 21230. She has specialized in the field of compulsive gambling since 1972.     

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.     

Gambling and Federal civil service employment law

Federal sector employment law concerning employee misconduct in which gambling is a factor has evolved significantly since the enactment of the Civil Service Reform Act of 1978, and is breaking new ground in this aspect of civil rights and employment law. Among other things, a debate is taking place in this sector as to whether compulsive gambling is a handicapping condition similar to alcoholism and drug addiction. Traditionally, disciplinary cases in the Federal Sector may be classified in two categories. The first involves misconduct related to compulsive gambling. The second concerns gambling on-the-job, either through promotion of gambling by, for example, running a numbers game, or by placing bets. While employees who promote gambling by running numbers games can be fired for just one instance of such misconduct, employees whose misconduct on or off the job is the result of compulsive or pathological gambling have a strong affirmative defense restricting the employer's attempts to fire for just cause. As defined by administrative agencies which have primary jurisdiction over Federal civil service law matters, compulsive gambling, generally, is not recognized as a handicapping condition. Developments in Federal sector, however, have required the federal manager to consider the existence of a condition of pathological gambling as a mitigating factor in deciding upon appropriate discipline. Other related developments indicate that compulsive gambling may, in fact, be reclassified as a handicapping condition.The author is an Assistant Professor (Adjunct) of Public Administration at John Jay College, C.U.N.Y., where he teaches Administrative Law and Regulation and Labor Relations in the Public Sector and Employment Discrimination Law in the Master of Public Administration Program. This article is adapted from remarks made at the Second Annual Conference on Gambling Behavior held at Philadelphia, PA, November 19–21 1986.     

Using Fear Appeals in Warning Labels to Promote Responsible Gambling Among VLT Players: The Key Role of Depth of Information Processing

Video lottery terminals (VLT) are a highly lucrative gambling format, but at the same time they are among the most hazardous. Previous research has shown that threatening warnings may be an appropriate approach for promoting protective behavior. The present study explores the potential benefits of threatening warnings in the fight against compulsive gambling. A 4 × 2 factorial design experiment was used to test our model based on both Elaboration Likelihood Model and Protection Motivation Theory. 258 VLT adult players (58% males, 42% females) with various degrees of problem gambling were exposed to three threat levels (plus a control condition) from two different sources (i.e., either a medical source or a source related to the provider of VLT’s). Our results show that both higher threat warnings and the medical source of warnings enhance Depth of Information Processing. It was also found that Depth of Information Processing affects positively attitude change and compliance intentions. The theoretical and managerial implications are discussed.     

Parents of male compulsive gamblers: Clinical issues/treatment approaches

This is a study of 126 parents (57 couples and 12 individual parents) of 69 inpatient pathological gamblers. The gamblers ranged in age from 17–37 years. All were males who dated their average age of onset of heavy gambling at 13–14 years. The parents ranged in age from 38–69 years. Treatment approaches specific to parents of compulsive gamblers are discussed. These approaches include education, family therapy, conjoint sessions, combined group, parent group, and aftercare. In addition, the value of self-help through GamAnon is stressed as a means of returning sanity to their lives and as a way of recognizing that these parents have the ability to change their feelings and their behaviors, thereby no longer making the gambler and his gambling the focus of their existence.     

A self-psychological study of a shared gambling fantasy in Eugene O'Neill's Hughie

This paper presents an applied psychoanalytic study of Eugene O'Neill's two-character play, Hughie. Applying the constructs of self psychology, the play illustrates both the narcissistic features and the emotional and behavioral characteristics of compulsive gamblers. The study focuses particular attention on the role of narcissistic fantasies—with both grandiose and megalomaniacal features—in affecting, temporarily, the mood of the characters. Moreover, it is shown that a shared gambling fantasy—a winner among winners—enables them to experience a sense of camaraderie, humanness, and the illusion of kinship.     

Compulsive gambling: Structured family intervention

Family intervention has been an effective procedure for getting alcoholics into treatment for more than twenty years. Now this technique is being used with compulsive gamblers. Because the gambling disorder is so easy to hide, the patient seems to be further into the illness by the time the family seeks help. Furthermore, because the gambling offers intermittent rewards, the denial in both the patient and family appears to be stronger than found with most alcoholics.During the intervention it is important to tell the compulsive gambler why the help of a professional was sought; what changes have been observed by family members and friends as a result of his/her gambling; how family relationships have been affected; what is feared will happen if he/she doesn't get help; and what each family member hopes will happen once the gambler is in recovery.Most concerned persons enter family interventions with the sole purpose of getting the gambler into treatment. However, since this is a family disease, ethically the primary goal of family intervention needs to be to getsomeone into treatment, if not the individual suffering with the disease then one or more of those concerned persons suffering from it.     

Minimal Treatment Approaches for Concerned Significant Others of Problem Gamblers: A Randomized Controlled Trial

The goal of this study was to examine the efficacy of minimal treatment interventions for concerned significant others (CSOs) of problem gamblers. One hundred and eighty-six participants (82% females, 56% spouses) were randomly assigned to one of three groups: the first minimal intervention group received a self-help workbook [based on behavioral principles, modified from the Community Reinforcement and Family Therapy (CRAFT) model] and the second minimal intervention group received the workbook plus telephone support. The control condition received a treatment resource information package. Overall, all participants reported significant improvement in personal and relationship functioning and gambling behavior and consequences at the 3- and 6-month follow-up. The data demonstrated differences in favor of the interventions in three areas: days gambling, satisfaction with the program, and number who had their needs met. There was no difference in the number who had entered treatment. It may be that CSOs require more guidance and follow-up support to achieve these goals using the CRAFT procedures and strategies.     

Raising the legal gambling age in Finland: problem gambling prevalence rates in different age groups among past-year gamblers pre- and post-implementation

This article reports on the frequency of problem gambling, measured with the Lie/Bet instrument, in different age groups among Finnish past-year gamblers in 2011 (n = 2984) and 2014 (n = 2326). The data highlights the situation before, and three years after, the implementation of a raised minimum age limit for gambling from 15 to 18 years. The difference in problem gambling frequency when comparing all age groups was statistically significant in 2011, but not in 2014. A significantly lower frequency of problem gambling was found among 18–19-year-olds in 2014 (3.4%), compared to 2011 (16.3%). The results regarding problem gambling prevalence among 15–17-year-olds (8.0% in 2011, 0.0% in 2014) are somewhat inconclusive as the number of respondents fulfilling the criteria for problem gambling was zero in 2014, thus affecting the analysis. No statistically significant difference in problem gambling frequency was found among 20–21-year-olds (a group less affected by the policy implementation) – or other older age groups – between the survey years. While the findings should be viewed with caution, they do support recommendations regarding a minimum gambling age of 18 years or higher as an effective harm-minimization measure.     

Stress,strain, coping and social support for affected family members attending the National Problem Gambling Clinic,London

Aims were: to compare burden experienced by affected family members (AFMs) attending a problem gambling treatment clinic in London, England with that of AFMs affected by substance problems; to examine socio-demographic correlates of AFM burden; to evaluate change following an intervention designed for AFMs; and to test the assumption of the stress-strain-coping-support (SSCS) model that change in AFM coping is important. AFMs (N = 215) completed a gambling version of the short questionnaire for family members affected by addiction (SQFM-AA) which assesses stressful impact, symptoms of ill health, ways of coping, social support and overall burden. All received a 5-Step Method workbook, based on the SSCS model. The SQFM-AA was repeated three to six months later (n = 96). T-test analyses showed that baseline burden and related variables were comparable to those of family members affected by substance problems, were greater for wives and those living in the same household as the gambling relative, and were significantly reduced at follow-up. Regression modelling indicated the importance, for AFMs’ health, of reduced levels of engaged-emotional coping. Family members affected by gambling, some subgroups especially, experience high levels of burden. They can benefit from a model-based intervention, and coping change may be an important process.     

Problem gambling: One view from the gaming industry side

An experienced lawyer for the gaming industry argues that the very appellation of compulsive gambling is misleading. Advocates of the medical model of compulsive gambling have created a strange new disease, where individuals are viewed as not responsible for their misdeeds but as solely responsible for their own cure. The fact that some individuals have problems because of gambling does not lead to the conclusion that casinos bear the ultimate legal or moral responsibility. More research and dialogue is needed; but so is the acceptance by problem gamblers and those who study and treat them that individuals have to take responsibility for their own conduct.     

Children of problem gamblers

An anonymous 37-item Health Survey was administered to 844 randomly selected ninth- to twelfth-grade students in four Southern California public high schools. Systematic information was gathered about their general health, quality of life, school and work adjustment, involvement with a range of potentially addictive substances and activities, and indications of psychosocial maladjustment, including difficulties with the law and suicide attempts. A series of self-ratings of students who characterized one or both of their parents as having a compulsive gambling problem (N=52) were contrasted with those of their classmates who reported no gambling problem among their parents (N=792). Findings have been grouped into three major areas: (a) comparative levels and reported effects of involvement with health-threatening behaviors (i.e., smoking, drinking, drug use, overeating, and gambling); (b) comparative incidence of psychosocial risk indicators (i.e., broken home, unhappy childhood and teenage years, legal action pending, overall quality of youth rated as poor); and (c) comparative incidence of dysphoria, school and work problems, and suicide attempts. Across each of these areas children of parents said to gamble excessively were found to be at consistently greater risk than their classmates who did not describe their parents as having a problem with compulsive gambling. These findings strongly suggest that without early and competent intervention, children of parents who gamble excessively: (a) will be seriously disadvantaged when attempting to solve their present adolescent and future adult problems of living; and (b) as a consequence are, themselves, high-risk candidates for developing one or another form of dysfunctional adjustment, including an addictive pattern of behavior.     

National survey on lifestyles and gambling in Serbia: gambling participation and problem gambling in adult population

The aim was to examine the association of socio-demographic and lifestyle characteristics with gambling severity level. The study was a part of the National Survey on Lifestyles in Serbia: Substance Abuse and Gambling, in 2014. The sample consisted of 5385 individuals. Based on the Problem Gambling Severity Index (PGSI) score participants were divided into non-problem gambling, low-/moderate-risk gambling and problem gambling. Prevalence of problem gambling was 0.5%, which was associated with having poor self-perceived financial status, having moderate or high risk for psychological distress, playing sports betting, casino games and slot machines. Low/moderate gambling was associated with having poor self-perceived financial status, number of drinking days per year, using any illicit drugs in the last 30 days, playing sports betting, slot machines, and online betting. Programmes of early detection of problem gambling should be developed, and regulation of availability of slot machines and sports betting.     

The self-exclusion program: legal and clinical considerations

In recent years, attention focused on compulsive gambling,¹ and its causes and cures, has increased at a notable rate. Among the measures taken to help the compulsive gambler is the voluntary² self-exclusion program which is either in place or being considered in various states.³ Although the programs differ from jurisdiction to jurisdiction, the basic premise is that the gambler requests that he be banned from the gaming establishment and/or removed from its mailing list. This article examines this new concept primarily from a legal perspective. The self-exclusion program represents a state-created legal entity constructed upon a clinical foundation. It prominently includes several clinical references to mental health principles. Of necessity, there appear some analogies to the field of substance abuse; these have provided at least a starting point for more particularized study and research in the fledgling field of compulsive gambling treatment.     

On Doing Research in a Clinical Setting

Abstract

Objective: To evaluate the efficacy of a stand-alone personalized normative feedback (PNF) intervention targeting misperceptions of gambling among college students. Participants: Undergraduates (N = 136; 55% male) who reported gambling in the past 30 days were recruited between September 2011 and March 2012. Methods: Using a randomized clinical trial design, participants were assigned to receive either PNF or an attention control task. In addition to self-report, this study used 2 computer-based risk tasks framed as “gambling opportunities” to assess cognitive and behavioral change at 1 week post intervention. Results: After 1 week, participants receiving PNF showed a marked decrease in perception of other students’ gambling, and evinced lower risk-taking performance on 2 analog measures of gambling. Conclusions: Changes in both self-reported perceived norms and analog gambling behavior suggest that a single, stand-alone PNF intervention may modify gambling among college students. Whether it can impact gambling outside of the laboratory remains untested.