Defining a threshold of harm from gambling for population health surveillance research

The measurement of harm in the context of non-problem gambling has received little attention from researchers in the field. Using the combined data from six provincial gambling surveys conducted in Canada between 2001 and 2005 (N = 12,285), we compared how different thresholds of defining gambling-related harm impacts prevalence, the relationship with indicators of gambling intensity and the characteristics of non-pathological gamblers who report experiencing below threshold symptoms of problem gambling. Survey items defining harm were drawn from the Problem Gambling Severity Index (PGSI) of the Canadian Problem Gambling Index. Three definitions of harm – reporting one or more problem gambling symptoms, reporting two or more problem gambling symptoms and having a PGSI score ≥ 3 – demonstrated a strong relationship with indicators of gambling intensity, and reliably differentiated low-threshold and zero symptom problem gamblers in terms of gambling characteristics and other risk factors.     

Pathological gamblers and their spouses: Problems in interaction

Two parallel self-administered surveys were distributed at three conferences of Gamblers Anonymous. One survey was for members of Gamblers Anonymous and the other was for members of GamAnon. Of the approximately 450 respondents, 302 were completed by the compulsive gambler and the spouse (N=151 couples). This article is a report on these 151 couples. The survey focused on two time periods — the gambler's time of torment, a phase spent in plumbing the depths of dread and despair, and the period of recovery following abstinence from gambling. Specific areas covered focus on the gambler's gambling activities, the spouse's awareness of problems, psychosomatic and emotional difficulties of the couple, sexual relationships, children's attitudes, and financial management. The respondents also indicated their need for specific therapy and workshops which could be provided by professional mental health counselors or at Gamblers Anonymous conferences.Based on a paper presented at the Seventh International Conference on Gambling and Risk Taking, Reno, August 22–26, 1987.     

Validation of the Consumption Screen for Problem Gambling (CSPG)

A 3 item screen for problem gambling was developed based on a conceptual analogue of the Alcohol Use Disorders Identification Test—Consumption (Bush et al. in Arch Intern Med 158:1789–1795, 1998); a brief screen that measures consumption rather than harm. Data were collected from an email panel survey of 588 men and 810 women (n = 1,398) across all states in Australia. Respondents indicated their consumption of gambling products using the 3 items of the new Consumption Screen for Problem Gambling (CSPG). Receiver Operating Characteristics curve analysis was used to analyze the performance of the new items relative to the Problem Gambling Severity Index (Ferris and Wynne in The Canadian problem gambling index: Final report, 2001). Results show a 98% probability that the CSPG score for a randomly chosen positive case of problem gambling will exceed the score for a randomly chosen negative case. In addition, a score of 4+ on the CSPG identified all 14 cases of Problem Gambling correctly, while only 7.3% of non-problem gamblers had scores of 4+ (sensitivity = 100%; specificity = 92.7%). Lastly, only 3.0% of respondents without any gambling problems had CSPG scores of 4+. The current study suggests that the CSPG, a brief consumption-based measure for gambling products, can quickly and accurately identify people who are likely to be experiencing gambling problems.     

Instant Ticket Purchasing by Ontario Baby Boomers: Increasing Risk for Problem Gamblers

Instant ticket purchase gambling (ITPG) is pervasive in Ontario and has features that mimic slot machine play. Previous researchers have reported that ITPG is one preferred activity for at-risk/problem gamblers. In the general Canadian population, rate of participation in ITPG is second only to lottery ticket gambling. Both are particularly favored by youth and seniors. The next cohort of seniors will be Canada’s baby boomers, one-third of whom live in Ontario. Secondary analysis of Statistics Canada data revealed that adults in this cohort who buy instant gambling tickets (N = 1781) are significantly different from the complete group of their age peers (N = 4266) in number of activities pursued and frequency of involvement. At-risk/problem gambling prevalence was 10.2% amongst Ontario baby boomers who participate in instant ticket gambling, significantly higher than the 6.7% found amongst the total group of baby boom gamblers. For those who reported experiencing one or more of the Canadian Problem Gambling Index indicators for problem gambling (N = 237), 73% were buying instant tickets. Future research should consider cohort effects and explore combinations of preferred gambling activities that may increase risk for problem gambling. Social policy recommendations include the use of all ITPG venues as key locations for promoting awareness of problem gambling treatment services. This work was funded by Ontario Problem Gambling Research Centre.     

Who Are the Anonymous? Involvement and Predictors of Gamblers Anonymous Attendance Among Disordered Gamblers Presenting for Treatment

Gamblers Anonymous is the most widely available form of support for disordered gambling. Although chapters exist worldwide, knowledge of how attendees interact with the program is limited. The present study aimed to investigate involvement in Gamblers Anonymous among attendees, motives for attendance, and overall satisfaction with the program. Furthermore, potential gambling-related predictors of attendance versus deciding not to attend Gamblers Anonymous were investigated. A treatment-seeking sample of disordered gamblers (N?=?512) from São Paulo, Brazil completed a series of self-report measures including an author-compiled Gamblers Anonymous survey. From the sample, 141 gamblers reported attending Gamblers Anonymous over the previous 30 days. An examination of involvement, satisfaction, and motives for attending Gamblers Anonymous was conducted, followed by regression analyses to assess predictors of attendance and satisfaction with the program. The majority of attendees (80%) reported some satisfaction with the program. The most common motive for attending Gamblers Anonymous was related to relapse prevention. Regression analyses revealed that greater gambling severity and number of days gambled were associated with not attending Gamblers Anonymous while giving testimonials was strongly related (OR?=?6.18) to satisfaction with the program. The findings of this study contribute to the literature on Gamblers Anonymous. In particular, that members derive great satisfaction from the program and see it as a way to strengthen their abstinence goals. However, despite high satisfaction, the results also suggest that most members were passively involved in the program. More research that assesses the effectiveness of Gamblers Anonymous as either a stand-alone or adjunct treatment is needed.     

Psychometric Evaluation of the Problem Gambling Severity Index-Chinese Version (PGSI-C)

The purpose of this study was to examine the psychometric properties of the Chinese 9-item Problem Gambling Severity Index (PGSI) derived from the 31-item Canadian Problem Gambling Index (CPGI) originally developed by Ferris and Wynne (2001). Exploratory factor analysis (EFA; n = 386; Group A data) and confirmatory factor analysis (CFA; n = 387; Group B data) on the Chinese student and community data (Mean age = 25.36 years) showed that a unifactorial model fitted the data with good reliability score (Cronbach’s alpha = 0.77). The concurrent validity of the PGSI-C was good in terms of the Chinese data matching the expected correlation between PGSI-C and other variables or scales such as SOGS, gambling frequency, gambling urge, gambling cognitions, depression, anxiety, and stress. The scale also reported good discriminant and predictive validity. In sum, the PGSI-C has good psychometric properties and can be used among Chinese communities to identify at-risk problem gamblers. Implications and suggestions for future research are discussed.     

Poker Mania and Problem Gambling: A Study of Distorted Cognitions,Motivation and Alexithymia

This study examines the relationships between distorted cognitions, motivation, and alexithymia on problem gambling in poker players (n = 96). Respondents completed questionnaires containing the Canadian Problem Gambling Index, Gambling Motivation Scale, Gambler’s Beliefs Questionnaire, and Toronto Alexithymia Scale-20. The results suggest that problem gambling is significantly related to distorted cognitions, non-self-determined motivation, and difficulty identifying feelings. Implications are drawn for the development of more relevant intervention, prevention, and treatment strategies.     

Pathological Gambling: Psychosomatic,emotional and marital difficulties as reported by the Gambler

Two parallel self-administered surveys were distributed at three conferences of Gamblers Anonymous. One survey was for members of Gamblers Anonymous and the other was for members of GamAnon. Approximately 500 respondents completed the surveys. This article is a report of some of the data from the gamblers' survey. This survey focused on two time periods of the compulsive gambler's life—during the desperation phase of the illness (Custer, 1982) and the phase following a period of abstinence from gambling. Specific areas covered in this preliminary report focus on the psychosomatic problems encountered by the gambler, emotional difficulties, sexual estrangement, and the need for mental health services. It is anticipated that some of these needs can be met through training or therapy sessions in professional gambling treatment centers and at Gamblers Anonymous conferences.This article is a revised version of a paper presented at the Sixth National Conference on Gambling and Risk Taking, Atlantic City, New Jersey, December 1984.Robert Yaffee computer scientist, was assisted by senior research assistants: Nancy Frankel, Danny Frankel, Deborah Becker, Douglas Rosen, Leslav Giermanski, Jaime Beauchamp, and Thomas Reingold. Other research assistants included Joseph Lautner, Trudy Myers, Arvind Chawla, and John Morales. To all of these individuals, the National Foundation for Study & Treatment of Pathological Gambling acknowledges its gratitude for their contribution to this project.     

Development and validation of the Protective Gambling Beliefs Scale (PGBS)

This article aimed to develop and validate a measure of protective beliefs – distinct from the absence of erroneous beliefs – that may be associated with resistance to gambling problems. Study 1 was designed to determine the reliability and content validity of a preliminary set of protective belief items. Participants (N = 1479, 813 males) also completed the Problem Gambling Severity Index (PGSI). Most items were associated with reduced risk of problems; however, items relating to an awareness of gambling harm, and preparedness to lose money were positively correlated with gambling problems and were therefore not demonstrably protective. Study 2 sought to reduce scale size and assess the scale’s ability to predict risk of gambling problems. Participants (N = 1168, 625 males) completed belief items, the PGSI, and measures of gambling consumption and cognitive distortions. Results showed that endorsement of protective beliefs was negatively correlated with PGSI, gambling consumption and cognitive distortions, and predicted PGSI above that of cognitive distortions. Findings suggest that the Protective Gambling Beliefs Scale (PGBS) offers a unique tool for understanding resistance to the development of gambling problems. Future research should focus on exploring whether protective beliefs can diminish the likelihood of the onset of problem gambling.     

Parents of young gamblers

A study of gambling among juveniles in the United Kingdom reveals that their favorite form of gambling, both in terms of percent participating and amounts spent, is playing Amusement with Prizes (i.e., slot) machines. These machines are widely, freely, and legally available to persons of all ages at amusement arcades, youth clubs, cafes, sports centers, bus and railroad stations, and other public settings. Before 1980, machine gamblers were rare at Gamblers Anonymous meetings. However, since that time, their numbers have increased rapidly, currently representing about half of all new members. Of these, 50% are described as children with the remainder in their late teens or early 20s.The balance of the paper describes the difficulties faced by the parents of these youth and the recent development and objectives of a unique self-help group called Parents of Young Gamblers.Editor's Note: Since this writing, P.O.Y.G. has channeled their energies into lobbying the Home Office to take action that would recognize slot machines as gambling devices, remove them from their present easy access to children, and restrict their availability to licensed Game Clubs where only registered adult members may play. The Home Office recently has agreed to place this matter under consideration.The Reverend Gordon E. Moody, M.B.E., was Secretary of the late (British) Churches' Council on Gambling. In the United Kingdom he is Honorary Founder-Patron of Gamblers Anonymous and Chairman of the Gamblers Anonymous General Services Board. He is Founder of Gordon House (a hostel for single, homeless compulsive gamblers) and Honorary Life Member of the Society for the Study of Gambling.     

Frequent Card Playing and Pathological Gambling: The Utility of the Georgia Gambling Task and Iowa Gambling Task for Predicting Pathology

The current investigation examined performance on two laboratory-based gambling tasks, the Georgia Gambling Task (GGT; Goodie, 2003. The effects of control on betting: Paradoxical betting on items of high confidence with low value. Journal of Experimental Psychology: Learning, Memory, and Cognition, 29, 598–610) and the Iowa Gambling Task (IGT; Bechara, Damasio, Damasio, & Anderson, 1994. Insensitivity to future consequences following damage to human prefrontal cortex. Cognition, 50, 7–15), as well as self-reported markers of gambling pathology using the Diagnostic Interview for Gambling Severity (DIGS; Winters, Specker, & Stinchfield, 2002. The downside: Problem and pathological gambling (pp. 143–148). Reno, NV: University of Nevada, Reno) among a sample of undergraduate students who are frequent card players. Two hundred twenty-one participants (55 female and 166 male; mean age 19.21 years) who self-classified as playing cards at least once per month completed these measures. Performance on GGT and IGT systematically related to gambling-related pathology in several ways. Overconfidence and bet acceptance on the GGT, and myopic focus on reward on the IGT, predicted gambling related pathology. GGT and IGT performance correlated with each other, but both contributed independently to predicting gambling pathology. Card playing frequency predicted gambling pathology but not GGT or IGT performance. Discussion focuses on the role of biases of judgment and risky decision making in pathological gambling.     

Really not god: Secularization and pragmatism in Gamblers Anonymous

The paper argues that despite maintaining the image of a twelve-step organization, the central theme of the history of Gamblers Anonymous (GA) in the United States is the increasing secularization of the program of the recovery. The paper documents the increasing secularization and pragmatism of Gamblers Anonymous, as reflected in key documents, despite the spiritual vision of its founding member. The author speculates on why Gamblers Anonymous took a secularized development path. Further research is called for.This research was supported in part by NIAAA post-doctoral grant, 2 T32 AA07240-11, at the Alcohol Research Group (ARG), Berkeley, California. I would like to thank ARG, Mary Phillips, the anonymous reviewers and editor of theJournal of Gambling Studies, Kathy Deierlein, Bob Yamashita, and anonymous members of Gamblers Anonymous. This paper is a revision of one presented at the Fifth National Conference on Gambling Behavior in Duluth, Minnesota during July, 1991.     

The Self-Regulation of Gambling

Despite the prevalence of gambling world-wide, relatively few individuals become problem gamblers. Additionally many problem gamblers recover without professional assistance. The current study aim was to examine how individuals self-manage their gambling through (a) assessing frequency of use of a range of self-regulation strategies (b) examining how these strategies cluster and (c) exploring relationships between strategies, gambling frequency, amount spent and problem gambling severity. A sample of 303 gamblers was recruited, over-sampling for problem gamblers as assessed by the Problem Gambling Severity Index (PGSI) of the Canadian Problem Gambling Index (mean age 26.4 years, SD = 10.1 years; 119 males, 184 females; 238 social gamblers, 63 problem gamblers, 2 unclassified). They rated extent of usage of 27 gambling self-management techniques and completed the PGSI and other gambling measures. Factor analysis of items produced five factors, named Cognitive Approaches, Direct Action, Social Experience, Avoidance and Limit Setting. The relationships between these factors and key gambling variables were consistent with hypotheses that problem gamblers trying to reduce their gambling would be more likely to use the strategies than other gambler groups. The potential for developing the factors into a Gambling Self-regulation Measure was explored.     

Development and Psychometric Evaluation of a 10-Item Short Form Inventory of Gambling Situations

The Inventory of Gambling Situations (IGS-63; Turner and Littman-Sharp, Inventory of gambling situations users guide, 2006) is a 63-item measure of high-risk gambling situations. It assesses gambling across 10 situational subscales that load onto two higher-order factors: negative and positive situations (Stewart et al. Psychology of Addictive Behaviors, 22:257–268, 2008). While the IGS-63 has excellent psychometric properties (Littman-Sharp et al., The Inventory of Gambling Situations: Reliability, factor structure, and validity (IGS Technical Manual), in press) its length may preclude its use in time-limited contexts. The purpose of this study was to develop and validate a 10-item short-form of the IGS (IGS-10). Each IGS-10 item reflects one of the ten subscale categories from the IGS-63, with two items from the original subscales included as examples for each IGS-10 item. The IGS-10 was administered to 180 undergraduate gamblers along with the IGS-63 and the Problem Gambling Severity Index (PGSI; Ferris and Wynne, Canadian Problem Gambling Index: Final report, 2001). IGS-10 items showed convergent validity with the corresponding IGS-63 subscales (r’s = .60–.73). Principal components analysis of the IGS-10 revealed two factors: negative (α = .84) and positive (α = .85). PGSI scores correlated significantly with all IGS-10 items (r’s = .33–.58) and with both IGS-10 higher-order subscales (r’s = .66 [negative] and .49 [positive]), supporting the criterion validity of the IGS-10. Since minimal information is lost when using the IGS-10, the short form may prove particularly useful when respondent burden prevents using the full IGS-63.     

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.     

Problem Gambling Inside and Out: The Assessment of Community and Institutional Problem Gambling in the Canadian Correctional System

This paper reports on the results of a multi-site survey of gambling behaviour and gambling problems amongst offenders in correctional institutions in Ontario, Canada, conducted between 2008 and 2011. A total of 422 (completion rate 61.5 %) incarcerated offenders (381 male and 41 female) took part in the study including 301 federal offenders and 121 provincial offenders. Based on the Problem Gambling Severity Index of the Canadian Problem Gambling Index (CPGI/PGSI) the prevalence rate of severe problem gambling was 8.9 prior to incarceration and 4.4 % during incarceration. These numbers are substantially higher than rates found among the general public. Thirty-four percent of the sample reported gambling in prison. Half of those who suffered from gambling problems before incarceration continued to have gambling problems during incarceration. People with problems related to slot machines prior to incarceration reported fewer gambling problems during incarceration compared to other problem gamblers.     

The Canadian Problem Gambling Index: An Evaluation of the Scale and Its Accompanying Profiler Software in a Clinical Setting

Across two studies we assessed the clinical utility of the Canadian Problem Gambling Index (CPGI). In Study 1, the scored items on the CPGI significantly correlated with those of the South Oaks Gambling Screen (SOGS), yet their shared variance was low. Importantly, clinician evaluation of the client’s level of pathology was more strongly associated with that revealed by the CPGI than the SOGS. In terms of utility, clinicians found the non-scored items on the CPGI more useful in treatment than those included with the SOGS. In Study 2, the effectiveness of the CPGI profiler (CPGI-P) software, which graphically depicts problematic gambling-relevant attitudes and behaviours, was assessed. Although clients had difficulties using the CPGI-P interface, they overwhelmingly indicated that the output prompted action to address their gambling. The clinicians were less enthusiastic as they felt the output did not help clients truly understand their gambling problems. Such sentiments were reiterated by the clinicians at a 6 months follow-up. The use of the SOGS and possible adoption of the CPGI (as well as the CPGI-P) in a clinical setting are discussed.     

Gambling Related Cognitions Mediate the Association Between Thinking Style and Problem Gambling Severity

This study examined the associations among thinking style (rational versus experiential), gambling related cognitions, and problem gambling severity. The participants were 70 female and 41 male regular gamblers who completed the Gambling Related Cognitions Scale (Raylu and Oei, Addiction 99:757–769, 2004), the Rational-Experiential Inventory (Pacini and Epstien, J Pers Soc Psychol 76(6):972–987, 1999), and the Problem Gambling Severity Index (Ferris and Wynne, The Canadian problem and gambling index: final report. Canadian Centre on Substance Abuse, Ottawa, 2001). Rational thinking was negatively related to problem gambling severity. Gambling related biases increased with problem gambling severity but the strength of those biases was dampened by rational thought. The patterns by which gambling related cognition mediated the association between thinking style and gambling severity suggest that therapeutic interventions may benefit from a consideration of a gambler’s thinking style.     

Personality, Perceived Luck and Gambling Attitudes as Predictors of Gambling Involvement

A quantitative observational study was undertaken to examine the relationship between individual factors and level of gambling involvement, in particular problem gambling (PG). The specific factors under study were personality, perceived luck, and attitudes towards gambling. A sample of university students (N = 185) completed a battery of questionnaires, consisting of the 16PF, Canadian Problem Gambling Index, Belief in Good Luck Scale (BIGL), Gambling Attitudes Scale (GAS), and the Impulsive Non-Conformity subscale (ImpNon) from the Oxford-Liverpool Inventory of Feelings and Experiences. Four groups were formed (Non-PG, Low-Risk, Moderate-Risk, and PG). Personality profiles varied between groups, and there were significant main effects and interaction effects on gender and personality factors. The PG group was higher on impulsivity, and belief in luck, and had more positive attitudes towards gambling. Multiple Regression Analysis and Discriminant Functions Analysis, using variables including some 16PF factors, BIGL and GAS variables, produced models that were highly predictive of gambling severity and gambling membership. In both models, impulsivity was the strongest predictor. These results were discussed in terms of their implications for future research and treatment of PG.     

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.