Gender Differences in Characteristics of Chinese Treatment-Seeking Problem Gamblers

A total of 952 (841 men and 111 women) Chinese treatment-seeking problem gamblers completed self-report assessment forms. Female in contrast to male gamblers were more likely to be older, married, less educated, and without employment. Female gamblers also started gambling at an older age, had a shorter gambling history, preferred casino and mahjong gambling, and reported more somatic complaints and suicidal thoughts. Male and female gamblers accumulated similar amount of gambling debt and reported an average of 12 gambling-related problems on the Chinese version of the South Oaks Gambling Screen [Lesieur and Blume (Am J Psychiatry 144:1184–1188, 1987)]. Both groups were similarly troubled by their indebtedness, inability to control gambling, and gambling-related interpersonal problems. However, female gamblers had fewer means to pay their gambling debt. Given that significant gender-related differences were observed in Chinese problem gamblers, prevention and treatment services should attend to specific needs of male and female gamblers.     

Measuring Attitudes Toward Empirically Supported Treatment in Real-World Addiction Services

Mental health workers with favorable attitudes toward empirically supported treatments (ESTs) are more likely to break through implementation barriers. The Evidence-Based Practice Attitude Scale has been shown to be reliable for mental health workers, but it has not been validated with addiction workers. This study investigates the use of the scale with a convenience sample of addiction workers from 4 agencies in 1 city. Results show that compared to mental health providers, addiction workers were more likely to view ESTs favorably if they were mandated and intuitively appealing. They also tended to rely more heavily on practical experience in forming attitudes toward treatment options. These results might help addiction agencies understand which types of workers are more likely to implement ESTs and inform effective engagement approaches specific to addiction workers.     

Impact of Race on the Implementation of Empirically Supported Treatments in Substance Abuse Treatment

The effort to address the gap between research and practice in substance abuse treatment has largely neglected the role of local resources and political trends. This study seeks to clarify the role of the local environment in implementing empirically supported treatments (ESTs). The study consisted of secondary data analysis of substance abuse treatment centers (N = 13,079) and U.S. Census data to determine the likelihood of using EST by substance abuse treatment centers in counties with 50% or more Black residents. Bivariate and multivariate models were employed. After controlling for various factors, results indicate that substance use disorder treatment agencies that accept federal funding are less likely to use ESTs if they are located in counties with predominantly (> 50%) Black residents. Implementation of ESTs could be influenced by community racial distribution (% Black), but environmental constraints and events might shift implementation patterns.     

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.     

Contingent Gambling-Drinking Patterns and Problem Drinking Severity Moderate Implicit Gambling-Alcohol Associations in Problem Gamblers

Although problem gambling and problem drinking often co-occur, the processes underlying this association are not well understood. This study investigated the effects of contingent gambling-drinking patterns and problem drinking severity on implicit gambling-alcohol associations. Participants were 144 (34 female) problem gamblers. The South Oaks Gambling Screen (SOGS) measured severity of problem gambling. The Brief Michigan Alcohol Screening Test (BMAST) measured severity of problem drinking. The Implicit Association Test (Greenwald, McGhee, & Schwartz, 1998, Journal of Personality and Social Psychology, 74, 1464–1480) measured gambling-alcohol associations. Participants who reported drinking when they won displayed faster response time (i.e., priming) on trials where alcohol words were paired with gambling win (e.g., jackpot) vs. gambling loss (e.g., forfeit) words. The tendency to drink in response to losses did not influence the priming effect of win cues or moderate the effects of Win-Drinking Pattern on priming. Severity of problem drinking on the BMAST also correlated positively the priming effects of win cues. These findings indicate that a tendency to drink in response to gambling wins and more severe alcohol problems each coincide with stronger associations between gambling win and alcohol concepts in memory. Such associations can promote drinking and its attendant effects (e.g., poor decision-making) in problem gamblers, and thus, may contribute to co-morbid gambling and alcohol use disorders.     

Brief Communications: Treating Problem Gamblers: A Residential Therapy Approach

The Gordon House Association (GHA) is the UK's only specialist and dedicated residential facility for problem gamblers. This paper describes the GHA therapeutic programme which is centred round a nine-month period of residency. Progression through the programme is described by overviewing each of the phases. These are initial assessment and five distinct phases comprising coping with today (Phase One), coping with yesterday (Phase Two), coping with change (Phase Three), coping with tomorrow (Phase Four), and coping on my own (Phase Five). These phases are themselves underpinned within the GHA core therapeutic approach which is also described.     

Factors Associated with Gamblers: A Population-based Cross-sectional Study of South Australian Adults

Objective To determine, using a random telephone survey, the prevalence of various gambling activities among South Australian adults, the prevalence of adult problem gamblers using the South Oaks Gambling Screen (SOGS) instrument, and to examine the problem gamblers by demographic and health-related risk factors.Method A random representative sample of South Australian adults selected from the Electronic White Pages. Overall, 6045 interviews were conducted (73.1% response rate) using Computer Assisted Telephone Interviewing (CATI) technology.Results Overall, 75.6% (95% CI: 74.5–76.7) of respondents had participated in at least one gambling activity during the last 12 months and 2.0% (95% CI: 1.7–2.4) were identified to be problem gamblers. A wide range of factors was associated with problem gambling at a univariate level, when compared to frequent gamblers. The logistic regression analysis highlighted that problem gamblers were more likely to speak a language other than English, be employed part time and a smoker when compared to frequent gamblers. Problem gamblers were also more likely to have a mental health condition (according to the Kessler 10), have had suicidal thoughts and know of services for gambling problems.Conclusion There is a wide range of characteristics associated with problem gambling in South Australia. All of these factors need addressing during policy development to assist problem gamblers.     

Characteristics and Gender Differences Among Self-Excluded Casino Problem Gamblers: Missouri Data

The present study explores gender-related differences in the demographic and gambling-related characteristics of 2670 problem gamblers participating in a state-administered (Missouri) casino self-exclusion program between 2001 and 2003. Female (n=1298, 48.4%) and male (n=1372, 51.1%) participants ranged in age from 21 to 84 years. Gender-related differences were noted among demographic variables, patterns of gambling behavior, reasons for self-exclusion, and involvement in self-help, counseling, and bankruptcy services. Female self-excluders were more likely than males to be older at time of application, African American, and either retired, unemployed or otherwise outside the traditional workforce. In addition, female self-excluders were more likely to report a later age of gambling onset, a shorter period between onset and self-exclusion, a preference for non-strategic forms of gambling and prior bankruptcy. The main predictors for female participation in self-exclusion included a desire to gain control and prevent suicide and referral by a counselor. The desire to save the marriage was a motivating factor for all participants. Findings suggest that the most efficacious treatment strategies with this group will include family systemic therapy and financial management in addition to pharmaco-treatment and culturally-sensitive individual therapy.     

Health Care Providers' Experiences with Problem Gamblers

The purpose of this study was to document health care providers' awareness of problem gambling and frequency of recognition and treatment. An exploratory survey was designed to collect data on awareness and knowledge of problem gambling. A structured questionnaire was completed anonymously by 180 health care providers (nurses, physicians, social workers, and other allied health professionals). Almost all respondents (96%) reported knowledge of problem gambling, and 30% reported asking clients about gambling problems when they presented with stress related symptoms. A third of the respondents reported identifying and treating clients for a gambling problem. The most frequently reported intervention was referral to counseling and other gambling resources. Respondents were generally interested in learning more about gambling problems, particularly those providers who have had a client discuss gambling related concerns. There were no significant differences in findings between provider groups.     

The Prevalence of Problem Gambling Among U.S. Adolescents and Young Adults: Results from a National Survey

A random telephone survey was conducted with a representative sample of 2,274 U.S. residents aged 14–21. The prevalence of problem gambling, as measured by the SOGS-RA, was 2.1%. Sixty-eight percent (68%) of the respondents had gambled in the past year, and 11% had gambled more often than twice per week. Males had much higher gambling involvement than females, and gambling involvement increased among older respondents. Blacks were less likely than average to have gambled in the past year, but if they gambled, they were more likely to do so frequently. Low SES respondents were less likely to have gambled in the past year, but if they gambled, they were more likely to be problem gamblers. Life transitions that are associated with assuming adult roles (employment, living independently of parents, non-student status) are also associated with greater gambling involvement. The rates of problem and pathological gambling were lower than those in an adult survey conducted earlier, when measured with the same questionnaire.     

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.     

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.     

Barriers to Treatment for Female Problem Gamblers: A UK Perspective

There is a paucity of research in the UK which examines problem gambling and that which does exist is mainly quantitative, focuses on male samples and fails to look at treatment seeking populations or obstacles preventing problem gamblers from seeking treatment. This paper presents findings from part of a larger qualitative study that explored the experience of treatment for female problem gamblers. Data were collected using semi-structured interviews with eight women who had received individual cognitive-behavioural therapy in the National Health Service for their gambling problem. An interpretative phenomenological analysis approach was applied in the research process, identifying three main themes, of which the subtheme ‘Barriers to Treatment’ is examined here. Internal and external barriers to treatment organically emerged in all female participants’ accounts and appear to have an impact on service utilisation. Input directly from gamblers can be combined with findings from other studies to devise better ways of reaching female problem gamblers. A better understanding of barriers to treatment can also provide valuable direction for future research and suggest applications in clinical service provision and treatment planning.     

Reward-Sensitivity,Inhibition of Reward-Seeking,and Dorsolateral Prefrontal Working Memory Function in Problem Gamblers not in Treatment

Given the central role of perseverative chasing in problem gambling, the present study sought to find evidence for three hypothesized components of perseveration in problem gamblers: reward-sensitivity dominance, deficient inhibition of reward-seeking behavior, and working memory deficits. This was the first attempt to examine working memory deficits in problem gamblers using a conditional association task, which is associated with posterior-dorsolateral prefrontal functioning. In a sample that was not in treatment, and representative in terms of comorbidity, problem gamblers performed significantly worse on the conditional association working memory tasks after controlling for general memory function, compared to demographically-matched controls. This is significant because deficits in the dorsolateral prefrontal region have been consistently associated with perseveration, which suggests that problem gamblers’ perseverative chasing may be associated with a working memory deficit. Problem gamblers were not significantly higher than at-risk gamblers in terms of reward-sensitivity dominance (measured as a personality trait in terms of extraversion) suggesting that it may not be specifically associated with problem gambling. Sensation-seeking was also not associated with problem gambling in a sample that corrected for the methodological problems of previous studies which examined it. The need for gambling research to focus specifically on the perseverative inability to stop gambling is emphasized, and the present findings of specific working memory deficits in problem gamblers suggest the need for further examination of working memory as a potential risk factor for problem gambling. We propose that subsequent studies examine working memory in terms of the self-regulatory capacity for goal maintenance where attention must specifically be allocated to resist interference.     

Overcoming Barriers to Using Empirically Supported Therapies to Treat Childhood Anxiety Disorders in Social Work Practice

Anxiety disorders are among the most common psychiatric disorders in children and adolescents. Most empirically supported treatments (ESTs) for pediatric anxiety disorders include various cognitive-behavioral methods. Although demonstrated efficacious in controlled and clinic settings, there are barriers to implementing these types of therapies in social work settings due to beliefs about the usefulness of ESTs in community settings; limitations of treatment manuals; time constraints of implementing ESTs; fidelity and flexibility of implementing ESTs; and limited training opportunities. This article provides an overview of ESTs for childhood anxiety disorders, highlighting options for overcoming common barriers to implementing ESTs. Collaborative multi-method approaches to advance implementation of ESTs in social work practice are suggested.     

Multidimensional Family Therapy: A Science‐Based Treatment System

MDFT is a family‐based intervention for adolescent substance abuse and associated mental health and behavioural problems (Liddle, 2010). Integrative in several ways, MDFT uses an ecological or contextual conceptual framework to understand the developmental tasks of teens and their families. Research‐derived knowledge about risk and protective factors, and proximal causes, correlates and contributors to adolescent drug and related problems inform clinical thinking and interventions with every case. A multisystems approach, MDFT assesses and intervenes in four areas: (1) the adolescent as an individual and a member of a family and peer network; (2) the parent(s), both as individual adults and in his or her role as mother; father or caregiver; (3) the family environment and family relationships, as manifested in day‐to‐day family transactional patterns; and (4) extrafamilial sources of influence such as peers, school and juvenile justice. Interventions are made within and coordinated across domains. Progress in one area or with one person has implications for and use in others. Individual meetings with parent(s) and teen set the stage for family sessions, and family meetings may offer content and new outcomes that need to be brought to extrafamily meetings with juvenile justice or school personnel. MDFT was developed and tested as a treatment system rather than a one‐size‐fits‐all approach. A treatment system offers different versions of a clinical model that vary according to factors such as clinical sample characteristics (older versus younger adolescents, juvenile justice involved versus no involvement in juvenile justice systems), and treatment parameters (type of clinical setting and treatment dose).     

Investigating non-gamblers: another step toward identifying potential protective factors against problem gambling

In this article it is argued that knowing more about non-gamblers could help researchers discover novel protective factors against problem gambling. The purpose of this study was to therefore to identify the sociodemographic, psychological and behavioural characteristics that are more prevalent among non-gamblers than among gamblers. Results from a logistic regression analysis with a representative sample of adults in the province of Quebec (Canada) revealed 12 significant predictors of non-gambling status. Among these predictors, seven were sociodemographic variables (i.e. birthplace, mother tongue, childhood religion, civil status, education, family income and family history of gambling problems), four were psychological variables (i.e. perception of one's financial situation relative to others, optimism concerning one's financial situation, beliefs concerning chances of winning, and suicidal ideation) and one variable was behavioural (i.e. church attendance). Further research including different types of variables and a common operational definition of non-gamblers is necessary to better understand this subgroup and its potential for possessing protective factors against gambling problems.     

Gender by Preferred Gambling Activity in Treatment Seeking Problem Gamblers: A Comparison of Subgroup Characteristics and Treatment Outcomes

Problem gambling is a growing public health concern and treatment incompletion levels remain high. The study aims to support and extend previous studies in relation to the heterogeneity of the gambling population based on gender and gambling type, and the implications of subgroup differences on treatment outcomes. Additionally, the concept of drop-out is addressed in terms of categorical treatment measures. The empirical findings are examined in the context of the theoretical framework of the pathways model. Participants were recruited from the Statewide Gambling Therapy Service and stratified into subgroups based on gender and gambling mode preference [Electronic Gambling Machines (EGM) or track race betters]. Baseline predictors collected and analysed using multinomial logistical regression included demographic information as well as gambling variables, while treatment outcomes consisted of three therapist rated measures. Significant differences between the subgroups were found for age, marital and employment status, gambling duration, alcohol use and the Kessler 10 measure of psychological distress. Specifically, male track race gamblers were younger, married, employed, had a longer duration of gambling, higher alcohol use and lower psychological distress relative to EGM users. No difference was found in any of the treatment outcomes, however, consistent with previous studies, all subgroups had high treatment incompletion levels. The findings demonstrate the importance of screening, assessing and treating problem gamblers as a heterogeneous group with different underlying demographics and psychopathologies. It is also hoped future studies will continue to address treatment incompletion with a re-conceptualisation of the term drop-out.     

Effectiveness of a Self Help Cognitive Behavioural Treatment Program for Problem Gamblers: A Randomised Controlled Trial

The study aimed to strengthen the scarce literature on self-help treatments for Problem Gambling (PG) by comparing the effectiveness of a Self-Help Cognitive Behavioral Treatment (SHCBT) program (n = 23) with a 6-week Waitlist condition (n = 32) in problem gamblers. Participants were community volunteers with gambling problems and were randomly allocated to the Waitlist and treatment conditions. Results showed significant improvements at post-treatment in gambling behaviors including frequency of gambling, average amount gambled per day and PG symptoms as well as a number of gambling correlates including psychological states (e.g., depression, anxiety and stress), gambling cognitions, gambling urges, gambling related self-efficacy, satisfaction with life, and quality of life among those who completed the SHCBT program, when compared with the waitlist condition. The effect size (partial η ²) ranged from .25 to .57 for all assessed outcomes that showed significant improvement from pre- to post-treatment. It was concluded that a self-help CBT program can be beneficial for treating community problem gamblers.