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.     

Alcohol Use and Prior Substance Abuse Treatment in Relation to Gambling Problem Severity and Gambling Treatment Outcome

Recent research has made it clear that problematic gambling is often accompanied by problematic alcohol use. Unfortunately, little is known about the nature of this association, especially as it relates to gambling treatment outcome. The purpose of this study is to explore the effect of current alcohol use level and previous substance abuse treatment on the symptoms of a large cohort of pathological gamblers as well as on their response to treatment for pathological gambling. The sample included 464 men and 301 women recruited at six gambling treatment programs in Minnesota. Gambling treatment patients were assessed on a number of gambling problem severity and related clinical variables using the Gambling Treatment Outcome Monitoring System (GAMTOMS). Patients with frequent alcohol use had greater gambling involvement at baseline than infrequent alcohol users. Patients with a previous history of substance abuse treatment had more severe psychosocial problems, ostensibly resulting from their gambling behavior, than patients without past substance abuse treatment. A MANOVA with repeated measures showed that neither pretreatment alcohol use, nor past substance abuse treatment exerted significant effects on gambling treatment outcome. While the level of pretreatment alcohol use and a history of substance abuse treatment are markers for greater gambling problem severity, treatment outcome for pathological gambling was not adversely impacted by these variables.     

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.     

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.     

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.     

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 and Problem Gambling among Recently Sentenced Male Prisoners in Four New Zealand Prisons

Recently sentenced inmates in four New Zealand male prisons (N = 357) were interviewed to assess their gambling involvement, problem gambling and criminal offending. Frequent participation in and high expenditure on continuous forms of gambling prior to imprisonment were reported. Nineteen percent said they had been in prison for a gambling-related offence and most of this offending was property-related and non-violent. On the basis of their SOGS-R scores, 21% were lifetime probable pathological gamblers and 16% were probable pathological gamblers during the six months prior to imprisonment. Of the “current” problem gamblers, 51% reported gambling-related offending and 35% had been imprisoned for a crime of this type. Gambling-related offending increased with problem gambling severity. However, only five percent of problem gamblers said their early offending was gambling-related. The large majority reported other types of offending at this time. Few men had sought or received help for gambling problems prior to imprisonment or during their present incarceration. This highlights the potential for assessment and treatment programs in prison to reduce recidivism and adverse effects of problem gambling and gambling-related offending.     

Primed for Change: Facilitating Factors in Problem Gambling Treatment

To successfully facilitate the treatment of problem gambling, change processes should be examined in order to identify those variables that differentiate good versus poor treatment outcomes. The current study explored the change facilitating effects of certain characteristics or conditions of an individual being treated: emotional support, instrumental support, emotional awareness, GA involvement, and depressed affect. These conditions were hypothesized to be predictive of a change-oriented mindset (i.e., “resources for change”) measured by abstinence self-efficacy, motivation for change, and readiness for change. Participants were 60 outpatients (54.2% male; M age = 46.7 years) with problem gambling recruited from several treatment centres throughout Ontario, Canada. Results indicated that: (1) depressed affect and emotional support seem to influence self-efficacy for abstinence, (2) emotional support alone appears to influence motivation for change, and (3) GA involvement, depressed affect, and emotional awareness, together, seem to influence readiness for change. These findings have implications for promoting change oriented dispositions in problem gambling individuals.     

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.     

Perceptions of the Extent of Problem Gambling Within New Casino Communities

Several recent studies using objective measures have found that the rate of pathological gambling in the U.S. is less than 5%. To determine the general population's perception of the prevalence of pathological gambling, a survey was conducted in seven communities where casinos have recently opened. Of the 1631 respondents who provided an estimate, the mean response was that 16% of the community residents were problem gamblers, more than three times the rate found by studies using specific diagnostic criteria. A regression equation found several demographic and attitudinal items are associated with higher prevalence estimates. In addition, the data support a close to home hypothesis that respondents who have relatives who have experienced problems with gambling will tend to perceive higher rates of problem gambling in the community.     

Problem Gambling and Comorbid Psychiatric and Substance Use Disorders Among Drug Users Recruited from Drug Treatment and Community Settings

Little is known about gambling rates of drug users recruited from drug treatment compared with those recruited from the community. We use the Diagnostic Interview Schedule (DIS) to provide lifetime prevalence estimates of problem gambling (i.e., at least one gambling problem) and DSM-III-R pathological gambling (i.e., at least four gambling problems) and describe the association between gambling and psychiatric disorders for drug users recruited from drug treatment settings (n = 512) and from the community (n = 478). We also report the relative risk of being a recreational and problem gambler in this sample. The sample was first interviewed in 1989–90 as a partof two NIDA-funded St. Louis-based studies. The prevalence of problem gambling in the overall sample was 22% and the prevalence of pathological gambling was 11%. There were no statistically significant differences in problem and pathological gambling rates for subjects recruited from drug treatment and those recruited from the community. The conditional prevalence rates, that is, the rate of problem and pathological gambling only among gamblers were 27% and 13.5%, respectively. Major findings indicate that problem gambling was associated with Antisocial Personality Disorder (ASPD), even after controlling for recruitment source and socio-demographic characteristics. In fact, when examining the temporal order of these disorders, we found that pathological gambling was always secondary to ASPD, occurring on average 11.4 years after the onset of ASPD. Problem gamblers, compared with everyone else, were more likely to be male, African-American, recruited from drug treatment, have ASPD and be dependent on illicit drugs. Multinomial logistic regression analysis predicted the relative risk of being a recreational and problem gambler (compared with a nongambler) in this sample according to socio-demographics, ASPD, and dependence on illicit drugs. Results imply that screening for gambling problems will need to be broad-based among drug users.     

Significant Others and Gambling Treatment Outcomes

Aims This study investigates the effect of significant others on treatment outcomes among treated pathological gamblers. Design This is a cohort study of individuals who received gambling treatment. Setting Oregon Problem Gambling Services (OPGS) for gamblers and their family members. Participants 4,410 adult gamblers who were discharged from treatment between August, 2001 and April, 2007. Measurements OPGS enrollment forms provided gambler gender, age, ethnicity, education level, employment status, gambling-related debt, and whether the gambler had a significant other at the time of enrollment. Termination forms provided information on the type of discharge (successful/unsuccessful) and treatment length (in days). Participation of the gambler’s significant other in the family treatment program was identified. Findings Results showed that age, ethnicity, gambling debt, and having a significant other are associated with the odds of successful treatment. Education level moderates the effect of having a significant other on treatment success. Age, ethnicity, education, employment, and having a significant other participate in treatment significantly impacted gamblers’ length in treatment. Conclusions These findings indicate that there may be a benefit to integrating significant others in gambling treatment methods. Significant others may act as social supports for gamblers seeking treatment, and involving loved ones in gambling treatment models may positively affect gambler treatment outcomes.     

Evaluating the Problem Gambling Severity Index

A large, integrated survey data set provided by the Ontario Problem Gambling Centre was used to investigate psychometric properties of the Problem Gambling Severity Index (PGSI). This nine-item self-report instrument was designed to measure a single, problem gambling construct. Unlike its nearest competitor—the South Oaks Gambling Screen (SOGS)—the PGSI was designed specifically for use with a general population rather than in a clinical context. The present analyses demonstrated that the PGSI does assess a single, underlying, factor, but that this is complicated by different, multiple factor structures for respondents with differing levels of problem gambling severity. The PGSI also demonstrated small to moderate correlations with measures of gambling frequency and faulty cognitions. Overall, the PGSI presents a viable alternative to the SOGS for assessing degrees of problem gambling severity in a non-clinical context.

Subtypes of Problem Gamblers,Sociocultural Factors,and Availability of Gambling

Finnish treatment-seeking gamblers were examined in light of predominant problem gambler subtype models. “Psy science” oriented problem gambler subtypes were found to be considerably influenced by gambling cultures and treatment traditions in the countries from which the mainstream problem gambler research originates. Thus, models that emphasize the psychopathology of the individual might cause some friction when applied to countries like Finland with a quite particular gambling culture and addiction treatment system that traditionally functions on a social work basis. It is suggested that specialists helping problem gamblers should acquire local knowledge with which to complete psychiatrically oriented scientific knowledge.     

The Iowa Gambling Treatment Program: Treatment Outcomes for a Follow-up Sample

The Iowa Gambling Treatment Program (IGTP) amassed participant data for gamblers and concerned others of gamblers over 4 years (1997–2001). Data collection opportunities included: (1) crisis contacts, (2) placement screening, (3) admission, (4) treatment services, (5) discharge, and (6) follow-up. Among followed gamblers, 74% of treatment completers, 49% of substantial treatment completers, and 36% of dropouts and referrals were abstaining from gambling at 6-month follow-up. The reduction in dollars lost to gambling was similar; 85% of treatment completers, 88% of substantial treatment completers, and 65% of others reduced their dollars lost per week. Although more extensive follow-up efforts are needed to properly evaluate the effectiveness of the IGTP, these results suggest that the IGTP shows promise.     

Conceptual and Methodological Issues in Treatment Outcome Research

Few studies have evaluated the comparative efficacy, effectiveness and mode of action of specific treatment interventions, or developed evidence-based best-practice management guidelines for the treatment of problem gambling. While individual and multi-modal programmes demonstrate positive results, systematic well-designed randomised controlled studies incorporating follow-up blind assessments and standardised diagnostic and outcome measures are needed to establish long-term outcomes.     

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.     

Outcome of Minnesota's Gambling Treatment Programs

This study measured the outcome of four state-supported outpatient gambling treatment programs in Minnesota. The programs were developed specifically for the treatment of pathological gamblers and offered multiple modalities of treatment including individual, group, education, twelve-step work, family groups, and financial counseling. The therapeutic orientation was eclectic with an emphasis on the twelve steps of Gamblers Anonymous (GA) and a treatment goal of abstinence. The sample included 348 men and 220 women treated between January 1992 and January 1995. A pretest-posttest design was utilized with multidimensional assessments obtained at intake, discharge, six-months, and twelve-months post-discharge. Variables assessed included a range of clinical and outcome variables. At six month follow-up, 28% reported that they had abstained from gambling during the six months following discharge and an additional 20% had gambled less than once per month. Almost half of the sample (48%) showed clinically significant improvement in gambling frequency at six monthfollow-up. Outcome variables of gambling frequency, SOGS scores, amount of money gambled, number of friends who gamble, psychosocial problems, and number of financial problems, all showed statistically significant improvements from pretreatment to follow-up. The treatment programs yielded outcome results similar to those reported for alcohol and drug abuse treatment programs.     

Problem Gambling in Non-English Speaking Background Communities in Queensland,Australia: A Qualitative Exploration

This paper provides an overview of qualitative research into problem gambling among non-English speaking background (NESB) communities in Queensland, Australia. The focus for this pilot study was the Chinese, Greek and Vietnamese communities. Using qualitative methodologies, this community-based research explored the motivations for gambling, and the impacts of problem gambling upon individuals and communities. Findings indicate that problem gambling is evident in each of the communities of study, but the issue is characterised by a pervasive sense of denial. Gambling is an issue of enormous shame and stigma, not only for the problem gambler but their entire family. As a result, most problem gamblers do not seek professional help but try to resolve the problem themselves or within the family unit. Research findings indicate that service access could be increased through a range of strategies including the provision of culturally appropriate community education and gambling help services, partnerships between NESB communities, gambling help services and community workers, and the development and implementation of preventative strategies.