Problem Gambling and the Circumstances Facing Older People

Local gambling venues are an important contemporary context for older people's gambling in many parts of the world typically being more accessible to this segment of the population than traditional, centralised gambling venues, such as casinos. This study, undertaken in South East Queensland, analyses older people's electronic gaming machine (EGM) behaviour and motivations, specifically in the context of licensed social and recreational clubs-a popular local gambling venue in many parts of Australia. The study gathered data via a postal survey of 80 managers of licensed clubs, interviews with Gambling Help services and a survey of 414 people aged 60+ who regularly play EGMs, self-administered on site at local clubs. The analysis undertaken suggests that certain age-related circumstances of older people-such as being without a partner, having a disability that impacts on everyday activities, having a low annual income, and no longer participating in the workforce-are associated with higher overall levels of motivation for playing EGMs and greater reliance on EGMs to meet social, recreational and mental health needs. Over a quarter of the older people surveyed (27%) reported drawing on their savings to fund their EGM gambling. Certain categories of older people, including those who were without a partner and those with a disability, were more likely to report drawing on their savings to fund EGM play and betting more than they could afford to lose, pointing to age-related vulnerabilities older people may experience to the negative impacts of gambling given the greater likelihood of their dependency on smaller, fixed incomes. The explanatory contribution of a range of demographic and motivational variables on problem/moderate risk gambling status was computed via a logistic regression model. Younger age (60-69), male gender, single marital status and being motivated to play EGMs to experience excitement and to win money all emerged as significant predictors in the model.     

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.     

Casino Gambling Among Older Adults in North Dakota: A Policy Analysis

This article examined social issues surrounding casino gambling among older adults both nationally and in the state of North Dakota. An exploratory review of gambling trends among older adults and an examination of policies to protect older gamblers revealed that older adults are targeted by the gaming industry as a lucrative market (Singh et al. J Retail Leisure Property 2007, 6(1):61–68). The authors used the national literature to frame their qualitative study, which explored gambling issues among older adults in North Dakota from the perspective of six counselors trained in gambling addiction who provide treatment services in the state. Findings indicated that relatively few policies existed at the state and national levels to protect older, more vulnerable adults who gamble. Further, the six casinos in North Dakota were viewed as very effective in marketing their casino gaming opportunities to older citizens by the gambling treatment providers interviewed. Additionally, barriers to gambling addiction treatment involved lack of available services and distance to receive services in this rural state. Based on the findings of this study, social policy changes which could lead to increased protection for older adult gamblers in the state were included.     

Problem and Probable Pathological Gambling Among Older Adults Assessed by the SOGS-R

This study had three main objectives: to examine the prevalence of gambling and problem gambling among older adults, to examine the socio-demographic and gambling patterns of people with various South Oaks Gambling Screen Revised (SOGS-R) scores, and to examine endorsement of the SOGS-R items. The data were drawn from telephone interviews conducted with a sample of 1000 older adults, 60 years and older, throughout the province of Manitoba. Problem gambling was determined from scores on the SOGS-R (Lesieur, H., & Blume, S. (1987). American Journal of Psychiatry, 144, 1184–1188; Lesieur, H., & Blume, S. (1993). Journal of Gambling Studies, 9, 213–219). The results showed gambling to be a fairly common activity among older adults, with 74.7% of participants having gambled in the year prior to the study. Of the total sample, 1.6% were gambling at problem levels, and a further 1.2% were gambling at probable pathological levels in the past year. Inspection of gambling patterns by SOGS-R score failed to reveal a clear and consistent distinction between problem gambling and probable pathological gambling. Finally, examination of item distribution revealed consistent trends of both over and under endorsement of certain items. These results suggest the need for either refinement of the SOGS-R for use with older adults, or the development of a new measure specific to older adults.     

Characteristics of Gambling Helpline Callers with Self-Reported Gambling and Alcohol Use Problems

The characteristics of problem gamblers calling the Connecticut Council on Problem Gambling (CCPG) gambling helpline during the years 2000–2001 (n = 960) were examined based on the presence or absence of self-reported alcohol use problems. A relatively low proportion of callers reported a problem with alcohol use (173/960 or 18.0%), and of those acknowledging an alcohol use problem, the majority reported a past rather than current problem (143/173 or 82.7%). A logistic regression analysis found that, as compared with problem gamblers denying any alcohol use problems, those reporting past or current alcohol use problems were more likely to be male and more frequently acknowledged problems with more forms of gambling, suicide attempts related to gambling, arrests secondary to gambling, daily tobacco use, drug use problems, prior substance abuse treatment, and family histories positive for alcohol and drug use problems. The findings highlight the strong relationship between alcohol use problems and other substance use problems, and suggest that problem gamblers with as compared with those without alcohol use problems demonstrate greater problems in multiple areas (arrest, attempted suicide) linked by impaired impulse control.Please address correspondence to Marc N. Potenza, Director, Problem Gambling Clinic; Director, Women and Addictive Disorders Core, Women’s Health Research at Yale; Yale University School of Medicine, Connecticut Mental Health Center, Room S-104, 34 Park Street, New Haven, CT 06519. E-mail: marc.potenza@yale.edu.     

Reasons for Seeking Help for a Gambling Problem: The Experiences of Gamblers Who Have Sought Specialist Assistance and the Perceptions of Those Who Have Not

This paper presents reasons for help-seeking data as reported by users of a national gambling helpline (help-seekers, HS, n = 125) as well as data pertaining to perceived reasons for seeking help as reported by gamblers recruited from the general population (non-help-seekers, NHS, n = 104). All data were collected via a structured, multi-modal survey. Participants in both groups considered help-seeking to be motivated by multiple factors (mean of 6.8 and 10.6 responses, respectively). Responses indicative of financial concern were most frequently reported by both HS and NHS participants (82 & 90%, respectively). Over a third of HS participants (35%) also identified financial concern as their primary reason for seeking help and 50% of NHS participants perceived financial concern to be the primary motivator for seeking help in a problem gambling context. Common types of secondary influence (other than financial concern) included psychological distress (HS & NHS participants), problem prevention (HS participants), rational thought (HS participants), physical health issues (HS participants), and relationship issues (NHS participants). The implications for promoting greater or earlier help-seeking activity amongst problem gamblers are discussed.

Evaluating the Problem Gambling Severity Index

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

Barriers to Help-seeking for a Gambling Problem: The Experiences of Gamblers Who Have Sought Specialist Assistance and the Perceptions of Those Who Have Not

This paper presents barriers to help-seeking data as reported by users of a national gambling helpline (help-seekers, HS, N = 125) as well as data pertaining to perceived barriers to seeking help as reported by gamblers recruited from the general population (non-help-seekers, NHS, N = 104). All data were collected via a structured, multi-modal survey. When asked to identify actual or perceived barriers to seeking help, responses indicative of pride (78% of HS participants, 84% of NHS participants), shame (73% of HS participants, 84% of NHS participants) or denial (87% of NHS participants) were most frequently reported. These three factors were also most often identified as the real or perceived primary barrier to help-seeking (collectively accounting for 55% of HS, and 60% of NHS, responses to this question) and were the only barriers to be identified by more than 10% of either HS and NHS participants without prompting. It was of note, however, that participants in both groups identified multiple barriers to help-seeking (mean of 6.7 and 12.2, respectively) and that, when presented with a list of 21 possible barrier items, NHS participants endorsed 19 of the listed items significantly more often than their HS counterparts. The implications of these findings, with respect to promoting greater or earlier help-seeking activity amongst problem gamblers, are discussed.

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.     

Gambling among culturally diverse older adults: a systematic review of qualitative and quantitative data

Culturally diverse older gamblers may face multiple jeopardies and socially structured challenges. In this first systematic review of empirical evidence of gambling in this population, the authors examined both quantitative and qualitative studies published between 1996 and June 2016. A thorough search of 7 databases yielded 18 articles with a total sample of 11,296 culturally diverse older adults. The review revealed contrary findings on the correlation between gender, education, income and gambling behaviour. Early onset was more frequently found among older adults who belonged to a culture that promoted tolerance of gambling activities; however, some developed a gambling habit after they had moved to a western society. Using an analytical framework, the authors demonstrate interrelated factors: enabling factors (cultural acceptance of gambling, supportive social networks, accessibility to gambling facilities and venues, and external cues); motivational factors (desire for excitement and winning money, coping with boredom, and stress due to structural issues); and buffering factors for culturally diverse older gamblers . Both environmental and personal factors could be triggered as buffers between gambling and culturally diverse older adults. In light of the motivational and enabling factors, practitioners and policy makers may need to step beyond focusing on ‘correction’ during intervention.     

Problem Gambling and Intimate Partner Violence

This study examined the prevalence and severity of intimate partner violence (IPV) among 248 problem gamblers (43 women, 205 men) recruited from newspaper advertisements. The main outcome measures used were the Canadian Problem Gambling Index, the Conflicts Tactics Scale-2, the State Trait Anger Expression Inventory-2, the drug and alcohol section of the Addiction Severity Index and the substance use section of the Structured Clinical Interview for the DSM-IV. In this sample, 62.9% of participants reported perpetrating and/or being the victims of IPV in the past year, with 25.4% reporting perpetrating severe IPV. The majority of the sample (64.5%) also had clinically significant anger problems, which was associated with an increased risk of being both the perpetrator and victim of IPV. The presence of a lifetime substance use disorder among participants who had clinically significant anger problems further increased the likelihood of both IPV perpetration and victimization. These findings underscore the importance of routinely screening gambling clients for anger and IPV, and the need to develop public policy, prevention and treatment programs to address IPV among problem gamblers. Future research to examine IPV among problem gamblers is recommended.     

Late Life Gambling: The Attitudes and Behaviors of Older Adults

For a significant number of retired older adults (aged 65+), gambling has become a new form of recreation and entertainment. While prevalence studies have examined the incidence of problem gambling in other age groups, little research attention has been paid to the impact of gambling on older adults since the increase in availability and accessibility of legalized gambling within the last ten years. This study investigated the prevalence of problem gambling behaviors (SOGS-R), depression (GDS-15), levels of life satisfaction (SWLS), and motivations for gambling among older adults. A total of 315 older adults completed the study questionnaire and were grouped and analyzed according to those sampled from gambling venues and those from within the community. Results of the study found the most frequent accession and spending on several types of gambling occurred among older adults who were sampled at gambling venues. Older adults who were sampled at gambling venues were also found more likely to have higher levels of disordered gambling than older adults from the community, as measured by the SOGS-R. Relaxation, boredom, passing time, and getting away for the day were also the most likely reported motivations for the older adults who were gamblingpatrons. These findings provide an initial profile of older adults and their attitudes, motivations and gambling behaviors.     

Psychophysiological and Subjective Arousal during Gambling in Pathological and Non-pathological Video Lottery Gamblers

Two groups of video lottery gamblers (pathological N =30, and non-pathological N =34) were compared while they participated in gambling and gambling related tasks using subjective ratings of excitement, electromyographic activity (EMG), skin conductance level (SCL) and heart rate (HR). Although the groups experienced similar levels of increased physiological response the pathological gamblers reported greater levels of subjective excitement. It was concluded that the pathological and non-pathological gamblers might perceive their responses to gambling and gambling related situations differently.     

Vulnerability and Comorbidity Factors of Female Problem Gambling

This study helps to address a deficiency of gender-specific research into problem gambling. It focuses on the gambling behaviors, family and personal histories and comorbid psychological disorders of 365 female gamblers from across Ontario, Canada, who responded to a mail-in survey. Specifically, this study looks at rates of depression and anxiety, concurrent struggles with other behaviors (such as alcohol and drug use, disordered eating, overspending and criminal activity) and abuse history reported by female gamblers. The reported rates are considerably higher than for the general female population. The findings of this study agree with previous research. They suggest that prevention strategies and treatment practices for female problem gamblers should take into account women’s mental health, addiction and trauma history as contributing factors in the development of problematic gambling.     

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.     

Urge to Gamble in a Simulated Gambling Environment

Cue reactivity, while increasingly recognized as a central feature of drug and alcohol addiction, is not well studied in gambling. We evaluated the urge to gamble in a simulated casino environment among frequent gamblers who alternated between cycles in which they observed others playing ten hands of Blackjack (first, third and fifth cycle) and cycles in which they played ten hands of Blackjack themselves (second and fourth cycle). The played cycles served as a manipulation for the observed cycles in terms of “priming” (having previously gambled in the environment vs. not) and “anticipation” (expecting more opportunities to gamble in the environment vs. not) and, thus, allowed these conditions: observed cycle 1 = anticipation (+) and prime (−); observed cycle 2 = anticipation (+) and prime (+); and observed cycle 3 = anticipation (−) and prime (+). Subjects’ urge to gamble was greater in the gambling environment than in a neutral setting and both positive anticipation and positive priming increased cue reactivity within the gambling environment. The frequency of gambling outside of the study did not affect cue reactivity. However, a preference for Blackjack (vs. other types of gambling) and observing winning (vs. losing) hands were both associated with stronger cue reactivity in the study. These findings contribute to our understanding of pathological gambling.     

Self-perception of Gambling Problems among Adolescents Identified as At-risk or Problem Gamblers

The relative influence of perceived familial addictive behaviors and personal gambling behaviors on adolescents' self-perceptions of gambling problems was examined. Students from five high schools in Connecticut (N = 3,886) were surveyed. Of those between the ages of 14 and 17 who scored two or more on the South Oaks Gambling Screen--Revised for Adolescents (n = 532; 72% male; 43% Caucasian), 14.3% reported having a current or past problem with gambling. Wagering larger amounts in a single day, gambling on a daily basis, and perceived presence of a family member with a gambling problem were associated with increased odds of self-perception of a gambling problem. Thus, adolescents who may be less likely to be identified for prevention efforts (due to lack of engagement in high stakes gambling or the real/perceived absence of a problematic gambler in the home) appear less likely to perceive a gambling problem. To advance prevention and treatment strategies, the apparent discrepancy between adolescents' self-perceptions and objective reports of problem gambling behaviors warrants further investigation.     

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.     

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.     

Gambling Behaviour and the Prevalence of Gambling Problems in Adult EGM Gamblers when EGMs are Banned. A Natural Experiment

In this article, findings of a panel study among former EGM gamblers are discussed. The data were collected in two waves during 2007, and 1293 people, 18 years or older, participated. The background for the study was the Norwegian ban on EGMs from 1 July 2007, and the aim was to investigate how this ban affected gambling involvement and problem levels in the sample. The analysis shows that gambling participation, gambling frequencies and gambling problems were reduced after EGMs disappeared from the market. There was no indication of the development of an illegal EGM market, or of substitution of EGMs with other types of gambling. A reduction in other types of gambling is interpreted as an indication of synergetic effects between games. Reduced gambling participation among the most active EGM gamblers, and among risk gamblers, shows that the reductions in gambling availability had an effect even on highly involved gamblers.