Measuring the Prevalence of Sector-Specific Problem Gambling: A Study of Casino Patrons

This study is the first attempt to measure the prevalence of problem gambling attributable to a specific sector of the gambling industry. One thousand, one hundred and five casino patrons in 40 casinos in the UK were interviewed, face-to-face. Respondents were screened for problem gambling using a multiple response version of DSM-IV (DSM-IV-MR). The study found support for Eadington's (1988) hypothesis, that UK casinos could be largely sustained by regular players, among whom the prevalence of problem gambling is high. The study also found support for the hypothesis that, to the extent different gambling sectors are patronised by demographically different client groups, so the problem gamblers associated with them will reflect these client groups. The problem gamblers among the regular casino patrons were demographically distinct from the problem gamblers in the sample who showed a preference for other gambling forms. Other key findings support those found in other jurisdictions. Sector-specific prevalence studies may be the next step forward in epidemiological research on problem gambling. They have the major advantage of netting significantly more problem gamblers from much smaller samples than similar studies in the general population. They also have the potential to reveal the proportion of problem gamblers attributable to each sector, along with their demographic characteristics. Such information would result in more specific information being available for regulators seeking to minimise the social impact of problem gambling and those involved in the development of prevention and treatment strategies.     

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.     

Barriers to Seeking Help for Gambling Problems: A Review of the Empirical Literature

This literature review summarizes recent empirical research on obstacles preventing problem gamblers from seeking treatment for their gambling problems. Relevant databases and bibliographies were searched for English-language papers and reports published since 1998. The only methodological requirement was that gamblers themselves be asked about reasons for not seeking help. Nineteen studies conducted in five countries were identified. All except one targeted adults. Despite differences in methodology, many of the same barriers to treatment were identified. Most commonly reported barriers were: wish to handle problem by oneself; shame/embarrassment/stigma; unwillingness to admit problem; and issues with treatment itself. The authors of the review argue that unwillingness to admit to the problem may be even more prevalent than is typically indicated by the results of barriers studies. Other frequently reported barriers included lack of knowledge about treatment options and practical issues around attending treatment. More research is needed on barriers to treatment-seeking experienced by subgroups of gamblers defined by culture, ethnicity, gender, age. Open-ended questioning methods can help provide insights into what barrier categories mean to different groups and individuals. Input directly from gamblers can be combined with information from other kinds of studies to devise better ways of reaching problem gamblers, especially those in underserviced populations. Electronic supplementary material  The online version of this article (doi:) contains supplementary material, which is available to authorized users.     

Prevalence of Adult Problem and Pathological Gambling between 2000 and 2005: An Update

Background Excessive gambling is a prominent Public Health problem with high prevalence rates in many countries. Substance abuse and other co-morbidities often constitute a major health hazard for the person which gambles with a loss of material and social resources, as well as being a major concern for his or her significant others. The present study updates and extends prevalence data to include work published between 2000 and 2005 in English and other European languages. Methods In a three-step search and exclusion process, studies with current adult prevalence rates were gathered. Results Almost all studies fulfil basic research standards. The weighted mean prevalence rates for excessive gambling (problem and pathological) are 3.0% for the South Oaks Gambling Survey (problem 1.2%; pathological 1.8%), 3.3% for the Canadian Problem Gambling Index (problem 2.4%; pathological 0.8%) and 3.1% for the DSM-IV (problem 1.9%; pathological 1.2%). Conclusion The prevalence rates are comparable and relatively stable between countries and across survey instruments, and do not differ from earlier reviews. The regular epidemiological monitoring of excessive gambling remains a major Public Health issue although the distinction between pathological and problem gambling is not appropriate for epidemiological research. Further studies are needed with respect to concomitant lifestyle characteristics.     

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.     

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.     

Risk Factors for Problematic Gambling: A Critical Literature Review

This article is a critical review of risk factors for pathological gambling categorized by demographics, physiological and biological factors, cognitive distortions, comorbidity and concurrent symptoms, and personality symptoms and characteristics. There is also a varia section (availability, parents playing, sensory characteristics, schedules of reinforcement, age of onset, and playing duration). The review found very few well established risk factors for pathological gambling (i.e. more than two studies to support the conclusions). Well established risk factors included demographic variables (age, gender), cognitive distortions (erroneous perceptions, illusion of control), sensory characteristics, schedules of reinforcement, comorbid disorders (OCD, drug abuse), and delinquency/illegal acts. An understanding of risk factors for pathological gambling should enhance prevention and treatment approaches.     

Developing the DSM-IV-DSM-IV Criteria to Identify Adolescent Problem Gambling in Non-Clinical Populations

This paper presents a revised version of DSM-IV-J criteria for youth, the DSM-IV-MR-J, together with psychometric data stemming from its use in a major prevalence study of adolescent gambling and problem gambling. The case is made for further development and testing of current and emerging instruments to screen for problem gambling in youth, with the aim of establishing one internationally accepted gold standard measure.     

Problem and Probable Pathological Gambling Among Older Adults Assessed by the SOGS-R

This study had three main objectives: to examine the prevalence of gambling and problem gambling among older adults, to examine the socio-demographic and gambling patterns of people with various South Oaks Gambling Screen Revised (SOGS-R) scores, and to examine endorsement of the SOGS-R items. The data were drawn from telephone interviews conducted with a sample of 1000 older adults, 60 years and older, throughout the province of Manitoba. Problem gambling was determined from scores on the SOGS-R (Lesieur, H., & Blume, S. (1987). American Journal of Psychiatry, 144, 1184–1188; Lesieur, H., & Blume, S. (1993). Journal of Gambling Studies, 9, 213–219). The results showed gambling to be a fairly common activity among older adults, with 74.7% of participants having gambled in the year prior to the study. Of the total sample, 1.6% were gambling at problem levels, and a further 1.2% were gambling at probable pathological levels in the past year. Inspection of gambling patterns by SOGS-R score failed to reveal a clear and consistent distinction between problem gambling and probable pathological gambling. Finally, examination of item distribution revealed consistent trends of both over and under endorsement of certain items. These results suggest the need for either refinement of the SOGS-R for use with older adults, or the development of a new measure specific to older adults.     

Pathways to Pathological Gambling: Component Analysis of Variables Related to Pathological Gambling

Research examining cognitive perceptions among children has suggested the importance of perceived skill and luck in initiating and maintaining gambling behavior. Using an experimentally manipulated gambling paradigm modifying rates of reinforcement the results suggest, in general, that one can modify these cognitions. More importantly, the results from the gambling task were found to generalize to multiple forms of gambling and were maintained over a relatively short period of time. The modifications of these perceptions appear to be easier for younger children (age 10 vs 12), with differential effects being found for boys and girls. The results are discussed in light of our current prevention initiatives and programs.     

Gambling motivations and superstitious beliefs: a cross-cultural study with casino customers

The expansion of legalized commercial gaming in Macau has motivated stakeholders to explore opportunities in other Asian countries. However, there is a lack of research focusing on casino customers in these markets. Thus, the purpose of this study is to explore gambling superstitious beliefs and motivations of those visiting a casino in South Korea, and how these factors are different across four ethnic groups. The researchers surveyed 323 casino customers in the lounge area on the casino floor, including Americans, Chinese, Japanese, and Koreans living abroad. This study found American gamblers could be characterized as more superstitious than Japanese gamblers, while the Chinese and American gamblers exhibited many similarities regarding the pattern of superstitious beliefs that they were most likely to endorse. The findings also suggest the culture and the area around the casino might be more important to Chinese, while novelty to Japanese and winning money to Korean gamblers are seen as most important. This study contributes to gambling literature by examining gamblers’ beliefs and motives in a different setting with more diverse populations than those in previous studies. The findings of this study will help casino operators properly develop and adjust strategies to thrive in the Asian marketplace.     

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.     

Temperament and Character in Pathological Gambling

Objective We have studied temperament and character in pathological gambling (PG). Methods Thirty-eight DSM-IV verified pathological gamblers (31 males and 7 females; mean age 35.4 ± 10.4 years) were tested with Cloninger’s Temperament and Character Inventory (TCI). Matched controls were chosen from the normal population. Results Pathological gamblers scored higher on the temperament factors novelty seeking (NS) and harm avoidance (HA). The most pronounced difference was found in the character factor self-directedness (SD). The pathological gamblers differed from controls in cooperativeness and self-transcendence. A personality disorder was found in 29% of the pathological gamblers 84% of whom scored either low on SD and high on impulsivity or had a more dishonest behaviour. Two-thirds of pathological gamblers showed immature character with or without high HA in temperament. The other third showed normal-character extravagant behaviour (86%), high impulsivity (36%) and less responsibility (50%) being the most common personality traits. Conclusion HA and NS might be trait-like characteristics in PG.     

The Experience of Gambling and its Role in Problem Gambling

This paper reports on the results of a psychological study conducted in Ontario, Canada, that attempted to answer the question of why some people develop gambling problems while others do not. A group of social gamblers (n = 38), sub-clinical problem gamblers (n = 33) and pathological gamblers (n = 34) completed a battery of questionnaires. Compared to non-problem gamblers, pathological gamblers were more likely to report experiencing big wins early in their gambling career, stressful life events, impulsivity, depression, using escape to cope with stress and a poorer understanding of random events. We grouped these variables into three risk factors: cognitive/experiential, emotional and impulsive and tested the extent to which each risk factor could differentiate non-problem and pathological gamblers. Each risk factor correctly identified about three-quarters of the pathological gamblers. More than half (53%) of the pathological gamblers had elevated scores on all three risk factors. Interestingly, 60% of the sub-clinical cases had elevated scores on only one risk factor. The results are interpreted in terms of a bio-psycho-social model of gambling addiction.     

Evaluation and Treatment of Pathological Gambling

The aim of this article was to describe a model for evaluating and implementing cognitive-behavioral treatment for pathological gambling. The model takes into account the fact that pathological gamblers form a heterogeneous group with varied biopsychosocial characteristics.     

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.     

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.     

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.     

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.     

Genetic Studies of Pathological Gambling: A Review of Methodology and Analyses of Data from the Vietnam Era Twin Registry

Twin studies represent an important and powerful approach to estimating the relative contributions of environmental and genetic factors to the expression of psychiatric illnesses. In this article, we first explain the rationale for using large populations of monozygotic and dizygotic twin pairs to estimate genetic and environmental contributions to a disorder and the statistical modeling associated with this approach. We then review results from studies of the Vietnam Era Twin Registry that use this methodology to examine the etiology of pathological gambling (PG) behaviors. The results provide strong evidence for genetic contributions to the development of PG in men and set the foundation for future studies aimed at identifying the manner in which specific genes and environmental factors individually and in conjunction contribute to PG.