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.     

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.     

Going on tilt: Frequent poker players and control

This paper is based on three years of participant observation in California's legal commercial card parlors and one year observation at an open meeting of Gamblers Anonymous (G.A.). The grounded concept, tilt, is advanced to describe the process of losing control in the gambling situation. Although some problem gamblers and most compulsive gamblers (members of G.A.) did not use this term, they, nonetheless, described the same process. Tilt is defined and broken down into its various components. Paths to, or ways of going on tilt and the means used to avoid tilt are spelt out. Hochschild's concept, emotion work, is used to describe how successful professionals stay off tilt. The major contention of the paper is that all gamblers experience tilt, and their reactions to tilt and to tilt-inducing situations partly determine whether or not gambling becomes a major problem. The implications of tilt are also discussed.I would like to thank Bob Yamashita, Ernie Fong, and Professor Troy Duster for comments on an earlier draft of this paper. I, however, am responsible for the final product. This is a revision of a paper presented at theSeventh International Conference on Gambling and Risk Taking in Reno, Nevada, August 1987. Requests for reprints should be sent to the author at the Institute for the Study of Social Change, University of California, 2420 Bowditch Street, Berkeley, CA 94720.     

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.     

Obsessive-Compulsive Features in Pathological Lottery and Scratch-Ticket Gamblers

The results of this study support the notion that pathological gamblers drawn from the community would score higher on all three scores from the YBOCS than light gamblers. Consistent with hypotheses, pathological gamblers (lottery and scratch ticket) reported more obsessions, compulsions, and avoidance behavior than the light gamblers, and also reported having more urges to engage in injurious behaviors to themselves and others. These findings provide evidence that pathological gambling falls in a spectrum or family of disorders which have obsessive-compulsive disorder at its core. These findings support McElroy, Hudson, Philips, et al.'s (1993) suggestions of similarities between OCD and Impulse Control Disorders, and extend Blaszczynski (1999) findings of overlap between pathological gamblers and OCD in a treatment population. Heavy gamblers also reported significantly more hoarding symptoms and compulsive buying than light gamblers. More research in this area may show further evidence of a spectrum of disorders with obsessive compulsive disorder at its core, and show further links between impulse control disorders (such as pathological gambling) and OCD.     

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.     

Gambling Patterns and Problems of Gamblers on Licensed and Unlicensed Sites in France

In 2010 France enacted a law to regulate supply and consumption of online gambling. Its primary aim was to protect citizens from gambling-related harm. This study aims to assess differences in gambling patterns and related harm between online gamblers who use licensed versus unlicensed sites. Participants (N = 3860) completed a self-administered online survey on gambling practices. Pairwise logistic regressions examined the association between the legal statuses of gambling sites people patronized and demographic variables and gambling types. Multivariate logistic regression models explored associations between gambling patterns and related problems according to the legal status of sites people have gambled on. Overall, 53.7 % of online gamblers report gambling exclusively on licensed sites. Those who bet on regulated activities on unlicensed sites, versus licensed sites, are more likely to be female, younger, less educated, inactive in the labor market and are more likely to perceive their financial situation to be difficult. Gambling on unlicensed sites is associated with more intense gambling patterns and more gambling-related problems compared to licensed sites. Findings demonstrate that gambling activities carried out on state licensed sites are associated with less overall harm to gamblers. Implications of these findings on future policy are discussed and prospective research directions are outlined.     

Pathological gambling: A comparison of gambling at German-style slot machines and “Classical” gambling

German-style slot machines and related legal issues are described. On the basis of a survey on 437 members of self-help groups (Gamblers Anonymous) in Germany, slot machine gamblers were compared with casino gamblers on such variables as sociodemographic data, gambling behaviour, financial expenditure, emotional experience while gambling, symptoms of pathological gambling, psychosocial consequences and gambling related delinquency. The casino gamblers' gambling behaviour is financially more extensive. There were similarities regarding the emotional intensity of the gambling experience. However the casino gamblers show more pronounced symptoms of pathological gambling and the psychosocial consequences of their gambling behaviour are more severe. In spite of these differences, the data show that for young people slot machines can be as stimulating and therefore as dangerous as casino gambling. The young slot machine gambler runs a similar risk of acquiring a pathological gambling habit as the casino gambler.I would like to thank Dr. Gerhard Meyer for his support and his comments on the first draft of this article which is based on data from a research project led by him.     

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.     

Compulsive gambling and the changing military law

Military courts have had to face the issue of compulsive gambling in criminal court-martial proceedings. The military recently switched from the liberal ALI definition of insanity to the much more stringent standards of the federal Insanity Defense Reform Act. However, military courts have not even allowed in expert testimony, holding the relevance of compulsive gambling has not been generally accepted in the scientific community. The rules involving extenuation or mitigation in sentencing allow much more leeway. Although compulsive gambling cannot be used as the basis for a defense of insanity in military courts, defense lawyers will continue to raise the issue in attempting to obtain lesser punishments for their military clients.B.S. Loyola College, J.D. Univ. of MD, Active duty Judge Advocate General's Corps, four years currently selected for promotion to Colonel, USAR. Partner, Stark and Little.B.A. 1982, Gettysburg College; J.D., 1987, Univ. of Balto.; Associate, Stark and Little, Baltimore, MD; member of the Baltimore City, Md. State, and Am. Bar Associations.     

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.     

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.     

Roulette gamblers and gamblers at electronic game machines: Where are the differences?

In an unselected group of 46 excessive gamblers who came for psychiatric help or for an expert opinion on legal responsibility, two different groups of gamblers are compared: roulette gamblers and those who played at German-style slot machines. In all excessive gamblers, childhood developmental limitations as well as disorders in the ability to form and maintain partner relationships in later life were frequent; at the same time the childhood conditions and their life histories are diverse. The spectrum of observed psychiatric disorders is rather wide. Gamblers at electronic game machines began to play at an average age of 19 years; they more often belong to the lower classes and show depressive and reactive disorders more frequently. Roulette gamblers began to gamble excessively on average nine years later than other gamblers; they showed signs of personality disorders, especially narcissistic and cyclothymic patterns, significantly more often. Anti-social behavior and delinquency before the onset of excessive gambling were frequent in both groups.     

Suicidality and depression among youth gamblers: a preliminary examination of three studies

Both suicide and problem gambling among youth are two growing areas of public health concern, though studies have yet to characterise the relationship between these issues. Youth report higher prevalence rates of problem gambling than adults, but no studies to date have investigated whether they are likewise prone to higher risks of gambling‐related suicidality. This article explores the relationship of depression, suicidality, and problem gambling in youth in three studies of middle and high‐school students (total N = 3,941; males n = 1,937, females n = 2,004) conducted in 1996, 2000, and 2001 in Quebec and Ontario. All studies reported significantly higher rates of suicidality among problem and pathological gamblers as compared to non‐gamblers and social gamblers, irrespective of gender, grade, or level of depression. The implications for future investigations are discussed.     

Predictability in Pathological Gambling? Applying the Duplication of Purchase Law to the Understanding of Cross-Purchases Between Regular and Pathological Gamblers

The objective of this study is to explore the gambling participations and game purchase duplication of light regular, heavy regular and pathological gamblers by applying the Duplication of Purchase Law. Current study uses data collected by the Australian Productivity Commission for eight different types of games. Key behavioral statistics on light regular, heavy regular, and pathological gamblers were computed and compared. The key finding is that pathological gambling, just like regular gambling, follows the Duplication of Purchase Law, which states that the dominant factor of purchase duplication between two brands is their market shares. This means that gambling between any two games at pathological level, like any regular consumer purchases, exhibits “law-like” regularity based on the pathological gamblers’ participation rate of each game. Additionally, pathological gamblers tend to gamble more frequently across all games except lotteries and instant as well as make greater cross-purchases compared to heavy regular gamblers. A better understanding of the behavioral traits between regular (particularly heavy regular) and pathological gamblers can be useful to public policy makers and social marketers in order to more accurately identify such gamblers and better manage the negative impacts of gambling.     

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.     

Characteristics of Older Adult Problem Gamblers Calling a Gambling Helpline

Background Few investigations have characterized groups of older adults with gambling problems, and published reports are currently limited by small samples of older adult problem gamblers. Gambling helplines represent a widespread mechanism for assisting problem gamblers to move into treatment settings. Given data from older adult problem gamblers in treatment, we hypothesized that older as compared with younger adult problem gamblers calling a gambling helpline would be less likely to report gambling-related problems.Design and methods Logistic regression analyses were performed on data obtained from January 1, 2000 to December 31, 2001, inclusive, from callers with gambling problems (N = 1,084) contacting the Connecticut Council on Problem Gambling Helpline.Results Of the 1,018 phone calls used in the logistic regression analyses, 168 (16.5%) were from older adults and 850 (83.5%) from younger adults. Age-related differences were observed in demographic features, types and patterns of gambling reported as problematic, gambling-related problems and psychiatric symptoms, substance use problems, patterns of indebtedness, and family histories of addictive disorders. Older as compared with younger adult problem gamblers were more likely to report having lower incomes, longer durations of gambling, fewer types of problematic gambling, and problems with casino slot machine gambling and less likely to report gambling-related anxiety, family problems, illegal behaviors and arrests, drug problems, indebtedness to bookies or acquaintances, family histories of drug abuse, and problems with casino table gambling.Conclusions Older as compared with younger adult problem gamblers calling a gambling helpline differ on many clinically relevant features. The findings suggest the need for improved and unique prevention and treatment strategies for older adults with gambling problems.     

Impaired Metacognitive Capacities in Individuals with Problem Gambling

Impaired insight into behavior may be one of the clinical characteristics of pathological gambling. In the present study, we tested whether the capacity to evaluate accurately the quality of one’s own decisions during a non-gambling task was impaired in problem gamblers. Twenty-five problem gamblers and 25 matched healthy participants performed an artificial grammar-learning paradigm, in which the quality of choice remains uncertain throughout the task. After each trial of this task, participants had to indicate how confident they were in the grammaticality judgements using a scale ranging from 1 (low confidence) to 7 (high confidence). Results showed that (i), problem gamblers’ performance on the grammaticality test was lower than controls’; (ii) there was a significant correlation between grammaticality judgments and confidence for control participants, which indicates metacognitive insight and the presence of conscious knowledge; (iii) this correlation was not significant in problem gamblers, which suggests a disconnection between performance and confidence in this group. These findings suggest that problem gamblers are impaired in their metacognitive abilities on a non-gambling task, which suggests that compulsive gambling is associated with poor insight as a general factor. Clinical interventions tailored to improve metacognition in gambling could be a fruitful avenue of research in order to prevent pathological gambling.     

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.