Alexithymia and Gambling: A Risk Factor for All Gamblers?

The purpose of this study was to investigate alexithymia (in relation with depression) in three groups of French gamblers (n = 186) recruited in their gambling location: at the racetracks (n = 80 males; mean age 28.1 years), in the slot machine rooms (n = 65; 29 males, 36 females; mean age 34.6 years), and in the traditional gaming rooms (n = 41 males; mean age 36 years). Gambling behavior was measured by the South Oaks Gambling Screen and DSM-IV criteria for pathological gambling, Alexithymia by the Toronto Alexithymia Scale (TAS-20) and depression with the Beck Depression Inventory (BDI-13). For racetracks and slot machine gambling, pathological gamblers differed from non-pathological gamblers, regarding their alexithymia scores. These results remained stable after controlling for depression scores among the racetracks gamblers only. The relationship between alexithymia and depression depends on the type of pathological gambler. These findings are consistent with the idea of identifying clinically distinct subgroups of gamblers.     

Comorbid mood and adjustment disorders among pathological gamblers seeking treatment in Hong Kong

Research findings on comorbidity and pathological gambling are non–existent in Chinese communities. The objectives of this study were to: (a) determine the prevalence of comorbid mood and adjustment disorders among pathological gamblers seeking treatment in Hong Kong; (b) compare demographic profiles and clinical features in pathological gamblers with and without comorbid mood and adjustment disorders; and (c) explore the association and temporal relationship between pathological gambling and comorbid mood and adjustment disorders. Assessment instruments included demographic data, BSI, SCID-I, ASI and LIFE-RIFT. Results showed that about two-thirds (63.7%; n = 128) of 201 participants reported lifetime comorbid psychiatric disorders. Most common comorbid disorders were mood disorders (29.4%; n = 59) and adjustment disorders (20.9%; n = 42). Pathological gamblers with comorbid mood or adjustment disorders showed more severe levels of psychopathology, impairment in psychosocial functioning and gambling problems. This study is important because it is the first scientific comorbidity study among pathological gamblers in a Chinese context.     

Risk Factors for Gambling Problems: An Analysis by Gender

Differences in problem gambling rates between males and females suggest that associated risk factors vary by gender. Previous combined analyses of male and female gambling may have obscured these distinctions. This study aimed to develop separate risk factor models for gambling problems for males and for females, and identify gender-based similarities and differences. It analysed data from the largest prevalence study in Victoria Australia (N = 15,000). Analyses determined factors differentiating non-problem from at-risk gamblers separately for women and men, then compared genders using interaction terms. Separate multivariate analyses determined significant results when controlling for all others. Variables included demographics, gambling behaviour, gambling motivations, money management, and mental and physical health. Significant predictors of at-risk status amongst female gamblers included: 18–24 years old, not speaking English at home, living in a group household, unemployed or not in the workforce, gambling on private betting, electronic gaming machines (EGMs), scratch tickets or bingo, and gambling for reasons other than social reasons, to win money or for general entertainment. For males, risk factors included: 18–24 years old, not speaking English at home, low education, living in a group household, unemployed or not in the workforce, gambling on EGMs, table games, races, sports or lotteries, and gambling for reasons other than social reasons, to win money or for general entertainment. High risk groups requiring appropriate interventions comprise young adults, especially males; middle-aged female EGM gamblers; non-English speaking populations; frequent EGM, table games, race and sports gamblers; and gamblers motivated by escape.     

Lifetime of Prevalence and Risk Factors of Problem and Pathologic Gambling in North Cyprus

In this article, the results of the national survey of adult gambling behavior in North Cyprus (NC) in 2012 are presented. The aim of this study is to investigate the characteristics of adults’ participation in gambling, and to determine the prevalence of ‘problem and pathological gambling’ in NC. The population of this study was formed from all the people living permanently in NC, speaking Turkish, and within the age group 18–65. Household interviews were conducted with 966 people. To obtain data, a 30 item questionnaire prepared by the researchers and a Turkish version of the Revised South Oaks Gambling Screen were used. Prevalence rates are compared with the results of the study conducted in 2007 using the same methodology and survey form. The lifetime prevalence of participating at least once in any of the 17 gambling activities investigated in the survey was 66.4 %. 3.5 % of the respondents scored as lifetime probable pathological gamblers and 9.2 % as probable problem gamblers. Risk factors for becoming probable problem and pathological gamblers include being male, being in the 19–28 age group, having a high education level, having a job and being born in Cyprus. This study shows that the prevalence of problem gambling is high in NC and increasing gradually. NC has socio-cultural features such as a history of colonization, socioeconomic problems and high unemployment, similar to other high prevalence gambling regions, which is suggestive of the importance of socio-cultural factors on gambling behavior.     

The Prevalence of Problem Gambling in Denmark in 2005 and 2010: A Sociodemographic and Socioeconomic Characterization

Gambling is a worldwide phenomenon. For most persons this causes only small or no problems, but for some, pathological gambling can be the result of entering the gambling environment. The objectives were to estimate the past year and lifetime prevalence of problem gambling in the adult Danish population (16 years or older) in 2010 and trends since 2005 and, furthermore, to investigate whether problem gamblers differed from non-problem gamblers with regard to sociodemographic and socioeconomic factors. Data were derived from two national representative Danish health surveys. The survey in 2005 was based on region-stratified random sample of 10,916 Danish citizens (response rate: 52.1 %) and the survey in 2010 was based on a random sample of 23,405 Danish citizens (response rate: 62.7 %). Problem gambling was defined using the lie/bet questionnaire. The past year prevalence of problem gamblers in Denmark remained stable from 2005 to 2010 (0.9 and 0.8 %, respectively). The highest past year prevalence of problem gamblers was found among young men in both 2005 and 2010. Furthermore, problem gamblers were more prevalent among men, disability pensioners, less educated and those not married or cohabiting. The present study indicates that a high level of education and being employed have a protective effect against problem gambling. More research is needed in order to understand what attracts and maintains the interest of men in gambling environments as well as why women are not occupied by gambling in the same degree as men.     

Sociodemographic Correlates and Morbidity in Lottery Gamblers: Results from a Population Survey

The aim of the current study was to examine the socio-demographic correlates, the association of mental and physical illness, and the prevalence of pathological gambling among three groups (1) those with lottery gambling only (2) those with lottery and other types of gambling and (3) those with other types of gambling only—such as playing cards, sports betting, horse racing, casino gambling etc. Data was used from a nationwide cross-sectional epidemiological nationally representative survey of the resident (Singapore Citizens and Permanent Residents) population in Singapore of 6616 Singaporean adults aged 18 years and older. All respondents were administered the South Oaks Gambling Screen to screen for pathological gambling. The diagnoses of mental disorders were established using the Composite International Diagnostic Interview and relevant socio-demographic data was collected using a structured questionnaire. Lottery gambling was by far the most popular form of gambling in Singapore, with 83.5 % of those who had ever gambled indicating that they had participated in lottery gambling. Those who participated in lottery gambling alone were more likely to belong to the older age group (as compared to the 18–35 years age group), be of Indian ethnicity, have a secondary or vocational education, and earn a lower income as compared to the other two groups. Our findings that those with pure lottery gambling were significantly less likely to be pathological gamblers and had significantly lower odds of psychiatric and physical morbidity as compared to the other two groups are unique and need further research.     

Gambling Participation and Problems Among Employees at a University Health Center

This study evaluated the frequency and intensity of gambling behaviors among employees at an academic health center. Employees were sent an anonymous questionnaire assessing demographic characteristics, participation in gambling activities, and gambling-related problems. Of the 904 respondents, 96% reported gambling in their lifetimes, with 69% gambling in the past year, 40% in the past two months, and 21% in the past week. The most common forms of gambling were lottery and scratch tickets, slot machines, card playing, sports betting, bingo, and track. Only 1.2% of the sample reported gambling on the internet. Using scores on the South Oaks Gambling Screen, 3.0% of the respondents were classified as Level 2 (or problem) gamblers, and an additional 1.8% were Level 3 (or pathological) gamblers. Compared to Level 1 (non-problem) gamblers, Level 2 and Level 3 gamblers were more likely to be male, single, and employed full-time, and to have lower income and education. About half of the Level 2 and Level 3 gamblers reported interest in an evaluation of their gambling behaviors and treatment interventions. These data suggest the need to screen for gambling problems in health care professionals and to provide gambling-specific treatments.     

Gender Differences among Adolescents with Gambling-Related Problems

Data from five recent studies using self-reports were merged to explore gender differences in the characteristics of adolescent problem gambling, including comorbidity with other youth problems. The sample consisted of 2,750 male and 2,563 female participants. Male problem gamblers were more likely than females to report signs of psychological difficulties while females were more likely to note behavioural problems as a consequence of their gambling problems. Males and females with severe gambling problems had remarkably similar prevalence rates of depression, substance use and weekly gambling. In the non-problem gambling group, depression was more likely to afflict females whereas substance use and frequent gambling were more prevalent among males.     

Problem Gambling Among Urban and Rural Gamblers in Limpopo Province,South Africa: Associations with Hazardous and Harmful Alcohol Use and Psychological Distress

Little is known about the mental health correlates of problem gambling in low- and-middle-income countries such as South Africa and whether these correlates vary by urbanicity. To address this gap, we examined mental health factors associated with problem gambling among gamblers in Limpopo Province, South Africa disaggregated by rural, peri-urban and urban location. A survey of gambling behaviour and mental health was conducted among 900 gamblers. Overall, 28.3 % were at high risk and 38.1 % were at moderate risk for problem gambling. For the entire sample, hazardous/harmful alcohol use was associated with almost twofold increased chance of being at moderate risk (AOR 1.83; 95 % CI 1.08, 3.11) and almost sevenfold greater odds (AOR 6.93; 95 % CI 4.03–11.93) of being at high risk for problem gambling. Psychological distress was associated with being at high risk for problem gambling only (AOR 1.18; 95 % CI 1.14–1.22). After stratifying by urbanicity, hazardous/harmful alcohol use and psychological distress remained associated with high risk gambling across all locations. We found little knowledge of a free gambling helpline and other gambling services—particularly in less urbanised environments [χ² (2), 900 = 40.4; p < 0.001]. These findings highlight the need to increase awareness of free helpline services among gamblers and to ensure gambling services include screening and treatment for common mental disorders.     

The Relationship Between Problem Gambling and Attention Deficit Hyperactivity Disorder

Recent studies indicate that treatment-seeking problem gamblers display elevated rates of ADHD and that adolescents who screen positive for ADHD are more likely to engage in gambling, develop gambling problems, and experience a greater severity in gambling problems. This study aimed to (a) compare the prevalence of ADHD in treatment-seeking problem gamblers to the general population; (b) investigate the relationships between ADHD and problem gambling severity, cluster B personality disorders, motor impulsivity, alcohol use, substance use, gender, and age; and (c) investigate the degree to which these factors moderate the relationship between ADHD and problem gambling severity. Participants included 214 adults (154 males, 58 females, 2 unspecified) who sought treatment for their gambling problems at a specialist gambling agency in Melbourne, Australia. Almost one-quarter (24.9 %) of treatment-seeking problem gamblers screened positively for ADHD, which was significantly higher than the 14 % prevalence in a community sample. ADHD was significantly positively correlated with problem gambling severity, motor impulsivity, and cluster B personality disorders, but was not associated with alcohol and substance use, gender or age. None of the factors significantly moderated the relationship between ADHD and problem gambling severity. These findings suggest that a considerable proportion of treatment-seeking problem gamblers report ADHD and that their clinical profile is complicated by the presence of high impulsivity and cluster B personality disorders. They highlight the need for specialist gambling agencies to develop screening, assessment, and management protocols for co-occurring ADHD to enhance the effectiveness of treatment.     

Internet Gambling Among High School Students in Hong Kong

The study investigated Internet gambling involvement and pathological gambling among Hong Kong adolescents aged 12–19 years. The diagnostic and statistical manual (4th edition) multiple response format for juveniles (DSM-IV-MR-J) (Fisher in J Gambl Stud 16:253–273, 2000) was filled by 1,004 students (597 boys, 407 girls) recruited by random selection of classes. The response rate was 86.6 %. Results indicate that more respondents participated in land-based gambling than Internet gambling (63.5 vs. 3.5 %) but online gamblers are 1.5 and 3.2 times more likely to develop pathological and at-risk gambling than non-Internet gamblers. Using the DSM-IV-MR-J criteria, 5.7 and 22.9 % of the Internet gamblers could be classified as at-risk gamblers and pathological gamblers, respectively. Majority (94.3 %) wagered online at home, and 91.4 % made their first bet before 18 years. Many perceived Internet gambling as a trendy (71.4 %) and safe entertainment (54.3 %). Problematic Internet gambling was significantly associated with the male gender, school grades, online gambling frequency, amount wagered and a gambling family environment. Survey results have implications for gambling research and preventive programs.     

An Empirical Study of Gender Differences in Online Gambling

Gambling has typically been considered a predominately male activity. However, recent prevalence surveys have shown greater numbers of females are now gambling. Much of the gambling literature suggests online gamblers are more likely to be male, and that problem gamblers are more likely to be male. Males and females are also likely to be gambling for different reasons and have a preference for different gambling activities. Little is known about the pattern of play among female online gamblers. The aim of this survey was to develop a better profile of female online gamblers and to examine any gender differences between males and females in terms of how and why they gamble online, their frequency of online gambling, patterns of play, as well as attitudes to online gambling. The survey was posted on 32 international online gambling websites and was completed by 975 online gamblers (including 175 female online gamblers). Chi-square tests of association were conducted to examine the association between gender and a range of variables. The results showed that females had been gambling online for a shorter duration of time than males, had much shorter online gambling sessions, different motivations for gambling online (i.e., to practice for free, to spend less money and out of boredom), and experienced online gambling differently to males, with increased feelings of guilt and shame for gambling online. This suggests there is still a stigma around gambling particularly evident among females in this study. The findings indicate that clinicians and treatment providers need to be aware of these potential gender differences in online gambling to develop appropriately tailored interventions.     

Prevalence of Problem Gambling Among the Prison Population in Hamburg,Germany

Despite the increasing research in gambling, the prevalence of problem gambling in the criminal justice population is rarely investigated, especially in Europe. Given the lack in knowledge the Hamburg study aimed at identifying the prevalence of problem gambling in the whole regional prison population. For this purpose two major approaches were used: a 10 months long-term screening of pre-trial detainees at prison entry through the Lie/Bet Questionnaire, and full-scale survey of inmate personnel records of prisoners being in prison on a defined reporting date. Based on 792 valid screening files 6.6 % of the pre-trial detainees were positive on the Lie/Bet Questionnaire, and these problem gamblers were male only. Among the 1,236 inmate personnel records reviewed in 7.3 % the records indicated problem gambling (90 prisoners). This indication was found in 7.5 % males and 3.6 % females. For almost half of the prisoners with problem gambling their prison sentence was related to their gambling behavior (46.7 %). These results are representative for the regional prison population, and the first of its kind in Europe.     

The prevalence of pathological gambling in Galicia (Spain)

Since 1977, when gambling was legalized in Spain, the amount of money spent on it has increased each year. Expenditures on gambling are now more than 3 billion pesetas per year. This paper provides the results of a study on the prevalence of pathological gambling in the Galicia region of northwest Spain, with a representative random sample (N=1,615) from the seven largest cities of Galicia. The prevalence of pathological gambling was 1.7% utilising the DSM-III-R diagnostic criteria. An additional 1.6% were problem gamblers, 0.6% excessive social gamblers and 1% exexcessive gamblers. The results suggest that slot machines are the most addictive form of gambling. Pathological gamblers are homogeneously distributed in the population with the exception that males and upper income family membership are overrepresented. Alcohol and cigarette consumption were higher among pathological gamblers than in the general population.This research was funded by the Service of Mental Health and Drug Abuse of the Health Authority of Galicia (SERGAS, Consellería de Sanidade). The author is grateful to M. José Fuentes, M. Carmen Carro, M. Angeles González, M. Carmen Lorenzo, Ana Pérez, Ana Sáinz, and Beatriz Torres for her help in collecting the data. I also thank Iain Brown for his helpful comments and English revision of this article. Paper presented at the Society for the Study of Gambling, London, November 1991.     

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.     

About the contributors

The paper reports secondary analysis of data from the 2010 British Gambling Prevalence Survey, a household survey of a representative sample of the population aged 16 years and over (N = 7756). Responses to questions about frequency of gambling and average monthly spend on each of 15 forms of gambling, and responses to two different problem gambling screens (DSM-IV and PGSI), were used to derive estimates, for each form of gambling separately, of the percentage of (1) all days play (two estimates), and (2) all spend (four estimates), attributable to problem gamblers. Although these estimates must be treated as approximations only, they demonstrate that problem gamblers make a far greater contribution to total gambling attendances and losses than problem gambling prevalence figures would suggest. There are certain forms of British gambling to which problem gamblers may be contributing as much as 20–30% of all days play and spend, and moderate risk gamblers a possible further 10–20%.     

Gambling Motives: Do They Explain Cognitive Distortions in Male Poker Gamblers?

Gambling behavior is partly the result of varied motivations leading individuals to participate in gambling activities. Specific motivational profiles are found in gamblers, and gambling motives are closely linked to the development of cognitive distortions. This cross-sectional study aimed to predict cognitive distortions from gambling motives in poker players. The population was recruited in online gambling forums. Participants reported gambling at least once a week. Data included sociodemographic characteristics, the South Oaks Gambling Screen, the Gambling Motives Questionnaire-Financial and the Gambling-Related Cognition Scale. This study was conducted on 259 male poker gamblers (aged 18–69 years, 14.3% probable pathological gamblers). Univariate analyses showed that cognitive distortions were independently predicted by overall gambling motives (34.8%) and problem gambling (22.4%) (p < .05). The multivariate model, including these two variables, explained 39.7% of cognitive distortions (p < .05). The results associated with the literature data highlight that cognitive distortions are a good discriminating factor of gambling problems, showing a close inter-relationship between gambling motives, cognitive distortions and the severity of gambling. These data are consistent with the following theoretical process model: gambling motives lead individuals to practice and repeat the gambling experience, which may lead them to develop cognitive distortions, which in turn favor problem gambling. This study opens up new research perspectives to understand better the mechanisms underlying gambling practice and has clinical implications in terms of prevention and treatment. For example, a coupled motivational and cognitive intervention focused on gambling motives/cognitive distortions could be beneficial for individuals with gambling problems.     

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.     

Gambling Participation and Problem Gambling Severity among Rural and Peri-Urban Poor South African Adults in KwaZulu-Natal

Poor South Africans are significantly poorer and have lower employment rates than the subjects of most published research on gambling prevalence and problem gambling. Some existing work suggests relationships between gambling activity (including severity of risk for problem gambling), income, employment status and casino proximity. The objective of the study reported here is to establish the prevalence of gambling, including at risk and pathological gambling, and the profile of gambling activities in two samples of poor South African adults living in a rural and a peri-urban community. A total of 300 (150 male, 150 female) adults in KwaZulu-Natal, South Africa in communities selected using census data, completed the Problem Gambling Severity Index and a survey of socioeconomic and household information, and of gambling knowledge and activity. It was found that gambling was common, and—except for lottery participation—mostly informal or unlicensed. Significant differences between rural and peri-urban populations were found. Peri-urban subjects were slightly less poor, and gambled more and on a different and wider range of activities. Problem and at risk gamblers were disproportionately represented among the more urbanised. Casino proximity appeared largely irrelevant to gambling activity.     

Problem Gambling Among International and Domestic University Students in Australia: Who is at Risk?

Young people are a high risk group for gambling problems and university (college) students fall into that category. Given the high accessibility of gambling in Australia and its association with entertainment, students from overseas countries, particularly those where gambling is restricted or illegal, may be particularly vulnerable. This study examines problem gambling and its correlates among international and domestic university students using a sample of 836 domestic students (286 males; 546 females); and 764 international students (369 males; 396 females) at three Australian universities. Our findings indicate that although most students gamble infrequently, around 5 % of students are problem gamblers, a proportion higher than that in the general adult population. Popular gambling choices include games known to be associated with risk (cards, horse races, sports betting, casino games, and gaming machines) as well as lotto/scratch tickets. Males are more likely to be problem gamblers than females, and almost 10 % of male international students could be classified as problem gamblers. Hierarchical regression analysis showed that male gender, international student status, financial stress, negative affect and frequency of gambling on sports, horses/dogs, table games, casino gaming machines, internet casino games and bingo all significantly predicted problem gambling. Results from this study could inform gambling-education programs in universities as they indicate which groups are more vulnerable and specify which games pose more risk of problem gambling.