Gambling and Problem Gambling in Sweden: Changes Between 1998 and 2009

Gambling participation and rates of problem gambling change over time in response to a variety of factors including gambling availability, demographic changes and adaptation at individual and societal levels. These relationship are complex and only partially understood. The major aim of the present study was to provide general population estimates of gambling participation and problem gambling for Sweden and compare these estimates with estimates from a previous national study. The study was also designed to identify risk factors for problem gambling including change in these factors over time. Data are from the first phase of the Swedish Longitudinal Gambling Study (Swelogs) in which a representative sample of 8,165 people was assessed using validated problem gambling and other measures to facilitate comparison with findings from the 1997/1998 Swedish Gambling Study (Swegs). Overall, it was found that gambling participation reduced markedly, although in some population sectors increases were evident for some forms including poker and electronic gaming machines. Lifetime prevalence of probable pathological gambling increased; however, past 12 months probable pathological and problem gambling prevalence did not. Males, younger adults and people born outside Sweden were at high risk in both studies. Significant prevalence increases were evident for people aged 18–24 and those with low levels of education. The results indicate that relationships between gambling exposure, participation and problems are dynamic with shifting implications for public health and social policy.     

Male Batterers’ Alcohol Use and Gambling Behavior

Little work has examined the interrelations among intimate partner violence (IPV), alcohol use, and gambling behavior, and no studies have examined these relationships among males court-ordered to batterer intervention programs (BIPs). The aim of the current investigation was to explore the associations between IPV, alcohol use, and gambling behavior among 341 males court-mandated to attend BIPs utilizing self-report measures. Voluntary, anonymous questionnaires were administered and completed during regularly scheduled BIP sessions. Compared to the general population, a higher percentage of the sample met criteria for pathological gambling (9%), and problem gambling (17%). Further, males exhibiting pathological gambling were more likely to be hazardous drinkers, and hazardous drinkers were more likely to exhibit pathological gambling. Additionally, pathological gamblers were at an increased risk for the perpetration of both physical and sexual aggression. Finally, gambling behavior uniquely predicted the perpetration of sexual aggression above and beyond alcohol use, impulsivity, and relationship satisfaction. The implications of these results for future research and intervention are discussed.     

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%.     

Behavioral Activation and Inhibition, Negative Affect, and Gambling Severity in a Sample of Young Adult College Students

The prevalence of pathological gambling among college students is increasing. Few studies have directly examined the relation between reward processing and gambling severity while concurrently examining the effects of co-occurring negative affect in this at risk population. This study used Structural Equation Modeling (SEM) techniques to analyze results from an online survey of 352 female and 96 male students age 18-25. Participants completed measures of past year gambling behavior and severity of gambling problems using the Canadian Problem Gambling Index and the Problem Gambling Severity Index. Negative affect and reward processing were measured by the 21-item version of the Depression, Anxiety, and Stress Scales and the Behavioral Inhibition System and Behavioral Activation System (BIS/BAS) scales, respectively. Thirty-five percent of participants reported gambling in the previous 12 months, and 11% had gambling severity scores indicative of "moderate-risk" or "problem gambling." Gambling severity was associated with negative affect. Negative affect, in turn, was correlated with the unitary BIS scale and inversely associated with the BAS reward responsiveness scale. Reward responsiveness was also inversely associated with gambling severity. In the SEM models, the association between reward responsiveness and gambling severity was mediated by negative affect among males but not among females. Potential explanations for these findings and their implications for addressing problem gambling are discussed.     

Risk Factors for Problem Gambling in California: Demographics,Comorbidities and Gambling Participation

While population surveys have been carried out in numerous jurisdictions internationally, little has been done to assess the relative strength of different risk factors that may contribute to the development of problem gambling. This is an important preparatory step for future research on the etiology of problem gambling. Using data from the 2006 California Problem Gambling Prevalence Survey, a telephone survey of adult California residents that used the NODS to assess respondents for gambling problems, binary logistic regression analysis was used to identify demographic characteristics, health-related behaviors, and gambling participation variables that statistically predicted the odds of being a problem or pathological gambler. In a separate approach, linear regression analysis was used to assess the impact of changes in these variables on the severity of the disorder. In both of the final models, the greatest statistical predictor of problem gambling status was past year Internet gambling. Furthermore, the unique finding of a significant interaction between physical or mental disability, Internet gambling, and problem gambling highlights the importance of exploring the interactions between different forms of gambling, the experience of mental and physical health issues, and the development of problem gambling using a longitudinal lens.     

Rates of pathological gambling in publicly funded outpatient substance abuse treatment

Rates of problem or probable pathological gambling were assessed in substance abusers seeking outpatient treatment in a publicly funded outpatient substance abuse treatment program. The South Oaks Gambling Screen (SOGS) was administered to 467 consecutive admissions at three different sites. Problem gamblers comprised 6.2 percent of the total (n=29), and 4.5 percent scored as probable pathological gamblers (n=21). These rates are two and one-half times greater than would be expected according to a recent state survey using the SOGS. Implications for assessment and treatment of problem gambling are discussed.The author expresses his appreciation to John Ramsay and the staff of Epoch Counseling Center for data collection; to Les Franklin for computational analysis; and Dr. Rachel Volberg for providing supplemental data from her Maryland State Gambling Survey.     

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

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

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.     

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.     

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.     

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.     

Prevalence Estimates of Adolescent Gambling: A Comparison of the SOGS-RA, DSM-IV-J, and the GA 20 Questions

Concerns over the rising prevalence of adolescent gambling problems have become more commonplace. A recent meta analysis of studies examining adolescent prevalence rates by Shaffer and Hall (1996) has suggested that between 77–83% of adolescents are engaging in some form of gambling behavior with between 9.9% and 14.2% of youth remaining at risk for a serious gambling problem. Their results further suggest that between 4.4% and 7.4% of adolescents exhibit serious adverse gambling related problems and/or pathological gambling behavior. Comparisons of studies are often difficult due to the use of alternative measures, differing classification schemes, and nomenclature. The present study examined the gambling behaviors of 980 adolescents who were administered three screening measures used with adolescents; the SOGS-RA, DSM-IV-J, and the GA 20 Questions. The DSM-IV-J was found to be the most conservative measure identifying 3.4% of the population as problem/pathological gamblers while the SOGS-GA identified 5.3% and the GA 20 Questions identified 6% of youth as experiencing serious gambling problems. The degree of concordance amongst the measures, gender differences, and classification systems are discussed.     

Gambling in Western and Eastern Europe: The Example of Hungary

The history of gambling in post-socialist countries is noticeably different from that of other countries in Europe. The goal of this study was therefore twofold: Firstly, to systematically review all European epidemiological studies related to excessive gambling in the general adult population, and secondly, to provide an overview of the state of gambling in Hungary based on the first ever nationwide representative survey, setting the results against the backdrop of the earlier European studies. A systematic review was carried out of European gambling studies which focus on a representative adult general population. Hungarian data was obtained from the National Survey on Addiction Problems in Hungary general adult population survey (N = 2,710). Pathological gambling was measured by the South Oaks Gambling Screen. Lifetime prevalence of excessive gambling (problem and pathological gambling) in the general adult population of European countries varies between 1.1% (Italy and Spain) and 6.5% (Estonia). In Hungary, the prevalence of problem gambling is 1.9%, with pathological gambling at 1.4%. The socio-demographic characteristics of the results are similar to those of other European countries. Using epidemiological data from the general adult populations of two post-socialist nations, it was possible to compare the results with data from 12 other European countries. Based on the data available, the extremely rapid liberation of the gambling market in the post-socialist countries has led to a similarly swift escalation in associated gambling problems.     

Prevalence and Correlates of Gambling Problems Among a Nationally Representative Sample of Brazilian Adolescents

The objectives of the study are: (a) to provide the first prevalence estimates of pathological gambling among Brazilian adolescents using an age-specific instrument in a nationally representative sample; (b) to investigate the extent to which adolescents participate in gambling activities in a developing country; and (c) to correlate different levels of gambling behavior with demographic variables. Multistage cluster sampling selected 3,007 individuals over 14 years of age from Brazilian household population. A total of 661 participants were between 14 and 17 years old. The Lie/Bet Questionnaire and the DSM-IV-MR-J were used for assessing problem and pathological gambling. 2.8% scored positive on the screening questionnaire, while 1.6% were classified as problem and pathological gamblers. Factors associated with problem and pathological gambling were male sex, not currently studying and considering religion as not important. Less than 4 months elapsed between the age of regular gambling involvement and the first gambling problem. Prevalence rates were quite similar from recent studies which used nationally representative samples. The association of problem and pathological gambling with male sex, school drop-out and low religiosity supports the Problem Behavior Theory. The fast progression to problem gambling adds evidence that adolescents may be more vulnerable to the effects of gambling.     

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

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

A Meta-analytical Synthesis and Examination of Pathological and Problem Gambling Rates and Associated Moderators Among College Students, 1987–2016

The problem of gambling addiction is especially noteworthy among college students, many of whom have the resources, proximity, free time, and desire to become involved in the myriad options of gambling now available. Although limited attention has been paid specifically to college student gambling in the body of literature, there have been three published meta-analyses estimating the prevalence of probable pathological gambling among college students. The research presented is the largest and most comprehensive, presenting an up-to-date proportion of those students worldwide exhibiting gambling pathology as assessed by the South Oaks Gambling Screen, and is the first to include estimates of sub-clinical problem gambling. A thorough literature review and coding procedure resulted in 124 independent data estimates retrieved from 72 studies conducted between 1987 and the present, surveying 41,989 university students worldwide. The estimated proportion of probable pathological gamblers among students was computed at 6.13%, while the rate of problem gambling was computed at 10.23%. Statistical significance was found in the influence of the percentage of non-white students on pathological gambling rates. The implications of this and other moderator analyses such as age and year of studies, as well as recommendations for future practice in dealing with college students and gambling disorder on campus are outlined and described in detail. Suggestions and rationales for future avenues of research in the area are also described.     

Testing the Emotional Vulnerability Pathway to Problem Gambling in Culturally Diverse University Students

Loneliness and adapting to an unfamiliar environment can increase emotional vulnerability in culturally and linguistically diverse (CALD) university students. According to Blaszczynski and Nower’s pathways model of problem and pathological gambling, this emotional vulnerability could increase the risk of problem gambling. The current study examined whether loneliness was associated with problem gambling risk in CALD students relative to their Australian peers. Additionally, differences in coping strategies were examined to determine their buffering effect on the relationship. A total of 463 female and 165 male university students (aged 18–38) from Australian (38%), mixed Australian and CALD (23%) and CALD (28%) backgrounds responded to an online survey of problem gambling behaviour, loneliness, and coping strategies. The results supported the hypothesis that loneliness would be related to problem gambling in CALD students. There was no evidence of a moderating effect of coping strategies. Future research could test whether the introduction of programs designed to alleviate loneliness in culturally diverse university students reduces their risk of developing problem gambling.     

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.