Urge to Gamble in Problem Gamblers Exposed to a Casino Environment

Cue-reactivity has received increased attention in addiction research, though not for gambling in particular. We examined cue reactivity in 18 problem gamblers by accompanying them to a gaming casino and measuring their subjective urge to gamble over a 1-h period. Half of the sample was additionally exposed to a gambling-specific negative mood induction (NMI) manipulation via guided imagery. Overall, about two-thirds of the sample reported moderate to high-gambling urges during the casino exposure. Additionally, the NMI reduced cue-reactivity. Finally, gambling urges in both groups decreased over the course of the exposure sessions. These findings suggest that a majority of problem gamblers experience the urge to gamble when exposed to gambling cues and that the intensity of these urges decrease with time, especially in the presence of a gambling-relevant NMI. Cue exposure should be studied further as a potential tool in the treatment of problem 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.     

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.

A Canadian Population Level Analysis of the Roles of Irrational Gambling Cognitions and Risky Gambling Practices as Correlates of Gambling Intensity and Pathological Gambling

Using population data (N = 11,562) drawn from five Canadian gambling prevalence surveys conducted between 2000 and 2005, the current study investigated the relationship between irrational gambling cognitions and risky gambling practices upon (a) gambling intensity, as measured by percent of income spent on gambling and (b) tolerance, a diagnostic indicator of pathological gambling. First, we found irrational gambling cognitions and risky gambling practices to be positively related. Second, irrational gambling cognitions moderated the relationship between risky gambling practices and gambling intensity. Specifically, people engaging in risky practices, spent less of their income on gambling when they had fewer irrational gambling cognitions compared to those with more irrational cognitions. Third, irrational gambling cognitions moderated the relationship between risky gambling practices and tolerance. Of the people engaging in risky practices, those with no irrational cognitions reported lower levels of tolerance than those with at least one irrational cognition. Interactions with gender are reported and discussed. These findings demonstrate the importance of both gambling cognitions and gambling practices upon the intensity of gambling and pathological gambling.

Measuring Self-efficacy in Gambling: The Gambling Refusal Self-Efficacy Questionnaire

This paper reports on the development and psychometric properties of a Gambling Refusal Self-Efficacy Questionnaire (GRSEQ). Two hundred and ninety-seven gamblers from both normal and clinical populations completed an initial set of 31-items of which 26 were selected for inclusion in the final version of the GRSEQ. A series of factor analyses showed four clear factors accounting for 84% of the variance. These factors can be summarised as situations and thoughts associated with gambling, the influence of drugs on gambling, positive emotions associated with gambling and negative emotions associated with gambling. The GRSEQ total score and factors scores showed high internal consistency (Cronbach’s alpha ranging from 0.92 to 0.98). Participants experiencing problems with gambling scored significantly lower on the GRSEQ, and discriminant analyses showed that the scale is able to correctly classify the non-problem (i.e., community and student samples) and problem gamblers (i.e., clinical sample). Furthermore, the GRSEQ showed significant negative relationships with other gambling-related variables (gambling urge and gambling-related cognitions) and negative mood states (depression, anxiety and stress) and was shown to be sensitive to change in treatment of pathological gambling. The results suggest that the GRSEQ is a useful measure of gambling refusal self-efficacy that is suitable for assessment of gamblers from both normal and clinical populations.     

How Do Gamblers End Gambling: Longitudinal Analysis of Internet Gambling Behaviors Prior to Account Closure Due to Gambling Related Problems

Objective: To examine behavioral patterns of actual Internet gamblers who experienced gambling-related problems and voluntarily closed their accounts. Design: A nested case–control design was used to compare gamblers who closed their accounts because of gambling problems to those who maintained open accounts. Setting: Actual play patterns of in vivo Internet gamblers who subscribed to an Internet gambling site. Participants: 226 gamblers who closed accounts due to gambling problems were selected from a cohort of 47,603 Internet gamblers who subscribed to an Internet gambling site during February 2005; 226 matched-case controls were selected from the group of gamblers who did not close their accounts. Daily aggregates of behavioral data were collected during an 18-month study period. Main outcome measures: Main outcomes of interest were daily aggregates of stake, odds, and net loss, which were standardized by the daily aggregate number of bets. We also examined the number of bets to measure trajectory of gambling frequency. Results: Account closers due to gambling problems experienced increasing monetary loss as the time to closure approached; they also increased their stake per bet. Yet they did not chase longer odds; their choices of wagers were more probabilistically conservative (i.e., short odds) compared with the controls. The changes of monetary involvement and risk preference occurred concurrently during the last few days prior to voluntary closing. Conclusions: Our finding of an involvement-seeking yet risk-averse tendency among self-identified problem gamblers challenges the notion that problem gamblers seek “long odds” during “chasing.”     

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.     

A Preliminary Investigation of Abstinence and Controlled Gambling as Self-Selected Goals of Treatment for Female Pathological Gambling

The current study aimed to provide a preliminary evaluation of the differential efficacy of a cognitive-behavioural treatment program for female pathological gamblers delivered with the goals of abstinence or controlled gambling. The findings were based on the comparison of pathological gamblers selecting abstinence and pathological gamblers selecting controlled gambling on measures of gambling behaviour and psychological functioning. The findings revealed that pathological gamblers selecting controlled gambling displayed comparable levels of improvement to those displayed by gamblers selecting abstinence. Using a treatment completer approach, 89% of the gamblers selecting abstinence compared with 82% selecting controlled gambling no longer satisfied the diagnostic criteria for pathological gambling by the completion of the 6-month follow-up period. Although further scientific demonstration is required, the findings of this study provide preliminary support for the practice of offering controlled gambling as an alternative goal in the treatment of pathological gambling.     

The Proxy Effect: Gender and Gambling Problem Trajectories of Iowa Gambling Treatment Program Participants

Recent research has found that men and women who end up in gambling treatment tend to follow different trajectories to that endpoint: women generally begin gambling later in life, but progress to problems and seek treatment more quickly. With women’s prevalence rates of gambling and disordered gambling increasing, it has become important to identify the causes and consequences of these trajectory differences. The current study used a sample of 2,256 gamblers enrolled in the Iowa Gambling Treatment Program to examine the relationship of gender and other demographic, economic and health-related (i.e., psychosocial) factors to empirically-identified gambling problem trajectories. The results indicated that gender made a statistically significant contribution to the prediction of trajectory, but increased predictive accuracy by only 1–2% beyond a model with psychosocial predictors. Gender’s contribution was limited to its relationship to age of initiation; men and women’s problem progression did not differ meaningfully once age of gambling initiation was taken into account. Gender is a unique contributor to the development of gambling problems among treatment seekers, but it is only one small part of the myriad psychosocial characteristics that influence gambling problem development.

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.     

Treatment of Female Pathological Gambling: The Efficacy of a Cognitive-Behavioural Approach

Given that a substantial proportion of current pathological gamblers are female, it is evident that women are underrepresented in the treatment outcome literature. The current study was designed to redress the limited information on the treatment of female pathological gambling. Although the use of cognitive-behavioural therapy is the most highly recommended approach as ‘best practice’ for the treatment of pathological gambling, no attempt to date has been made to evaluate the efficacy of this approach for female pathological gambling. Nineteen female pathological gamblers with electronic gaming machine problems were treated with a cognitive-behavioural program. While pathological gamblers placed on a waiting list did not show significant improvement on gambling behaviour and psychological functioning measures, the female pathological gamblers showed significant improvement on these measures over the treatment period, and maintained this improvement at the 6-month follow-up evaluation. By the completion of the follow-up period, 89% of participants no longer met diagnostic criteria for pathological gambling. Although further scientific demonstration and replication are required, the outcomes of this study indicate that the therapy that is considered ‘best practice’ in the treatment of pathological gambling is effective for female pathological gambling.     

A Cross-Cultural Study of Gambling Behaviour Among Adolescents

This study investigated whether the prevalence of weekly and problem gambling among youth varied according to cultural affiliation. A convenience sample of 1,265 Quebec high school students aged 12–18 was divided into three linguistic groupings: Anglophone (English), Francophone (French), and Allophone (other). Results revealed that the Allophone grouping contained the highest proportion of youth who gambled on a weekly basis and who reported gambling problems, followed by the Anglophone, and finally the Francophone groupings. Acculturation difficulties were associated with problem gambling. Few meaningful between-group differences were found with respect to factors related to problem gambling (i.e., comorbidity with other risk factors, coping, family functioning and resiliency). The results are discussed with respect to the influence of cultural background on gambling behavior.     

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.     

Examining DSM-IV Criteria for Pathological Gambling: Psychometric Properties and Evidence from Cognitive Biases

We examined the DSM-IV criteria for pathological gambling as assessed with the DSM-IV-based Diagnostic Interview for Gambling Severity (DIGS; Winters, Specker, & Stinchfield, 2002). We first analyzed the psychometric properties of the DIGS, and then assessed the extent to which performance on two judgment and decision-making tasks, the Georgia Gambling Task (Goodie, 2003) and the Iowa Gambling Task (Bechara, Damasio, Damasio, & Anderson, 1994), related to higher reports of gambling pathology. In a sample of frequent gamblers, we found strong psychometric support for the DSM-IV conception of pathological gambling as measured by the DIGS, predictive relationships between DIGS scores and all cognitive performance measures, and significant differences in performance measures between individuals with and without pathological gambling. Analyses using suggested revisions to the pathological gambling threshold (Stinchfield, 2003) revealed that individuals meeting four of the DSM-IV criteria aligned significantly more with pathological gamblers than with non-pathological gamblers, supporting the suggested change in the cutoff score from five to four symptoms. Discussion focuses on the validity of the DSM-IV criteria as assessed by the DIGS and the role of cognitive biases in pathological gambling.     

Pathological Gambling in Estonia: Relationships with Personality,Self-Esteem,Emotional States and Cognitive Ability

Due to changes in gambling accessibility during the last decade gambling has become more widespread in Estonia and the prevalence of pathological gambling has sharply increased. The present study attempts to identify psychological characteristics of Estonian pathological gamblers. It has been shown that a wide range of social, economic, and individual factors (e.g. personality traits and emotional states) predict the likelihood of becoming a pathological gambler. In the present study, pathological gamblers’ (N = 33) personality traits, self-esteem, self-reported emotional states and cognitive ability were compared to the respective characteristics in a non-gambling control group (N = 42) matched for age, gender and educational level. It was found that compared to controls, pathological gamblers had higher scores on Neuroticism (especially on its immoderation facet) and lower scores on Conscientiousness (especially on its dutifulness and cautiousness facets) and on self-esteem scale. They reported more negative emotional states during the previous month (especially depression and anxiety). Finally, pathological gamblers had lower general cognitive ability. In a logistic regression model, the likelihood of being a pathological gambler was best predicted by high immoderation score and low cognitive ability.

Psychosocial Factors Related to Gambling Abstinence and Relapse in Members of Gamblers Anonymous

Problem gamblers account for almost one-third of the industry’s total revenue with the adverse effects of problem gambling including significant financial loss, legal and occupational difficulties, family problems, psychological distress and suicide. As such, it is important to understand the influential factors in gambling abstinence and relapse, which will assist in the development of relapse prevention methods in therapeutic treatment regimes. This paper reported the role of a set of seven predictors in distinguishing between abstinent and relapsed gamblers among 75 Gambling Anonymous (GA) members (55 males; 20 females; Mean age 45 years) in Southeast Queensland. The measures taken were meeting Attendance and Participation, Social Support, God Belief, Belief in a Higher Power, Working the 12-steps of Recovery, Gambling Urges and Erroneous Cognitions. Discriminant analysis revealed that the variables separating the two groups were significant, suggesting that GA members achieving abstinence could be distinguished from those who relapsed, with Attendance and Participation, and Social Support contributing the greatest influence on member’s ability to abstain from gambling. The findings suggested that GA member’s involvement in meetings, and support from family and friends had significant impact on their gambling abstinence. In contrast, increased gambling urges and erroneous cognitions increased the chance of relapse.     

Full of Sound and Fury,Signifying Something: The Impact of Autonomic Arousal on EGM Gambling

An experiment was conducted to observe the influence of autonomic arousal on subsequent gambling behavior. Thirty-seven male and 32 female regular Electronic Gaming Machine (EGM) players were recruited through newspaper advertisements. Participants were randomly assigned to either: (1) a control condition, or (2) an experimental condition that introduced a loud white-noise event (80 db) at fixed 120 s intervals throughout the 5-min EGM gambling session. Galvanic Skin Response (GSR) measurements showed that the manipulation was successful in elevating autonomic arousal. The results showed differences in behavioral response to the manipulation based on prior experience with gambling problems. Persons with many gambling problems had lower average bet-sizes in the white-noise condition compared to the control, while those with few or no problems had higher average bet-sizes. The results suggest that arousal may provide different signals to gamblers with few versus many problems. Gamblers with many problems may interpret their arousal as a sign that they will soon lose money, while gamblers with few or no problems may associate feelings of arousal exclusively with winning.     

Temperament and Character in Pathological Gambling

Objective We have studied temperament and character in pathological gambling (PG). Methods Thirty-eight DSM-IV verified pathological gamblers (31 males and 7 females; mean age 35.4 ± 10.4 years) were tested with Cloninger’s Temperament and Character Inventory (TCI). Matched controls were chosen from the normal population. Results Pathological gamblers scored higher on the temperament factors novelty seeking (NS) and harm avoidance (HA). The most pronounced difference was found in the character factor self-directedness (SD). The pathological gamblers differed from controls in cooperativeness and self-transcendence. A personality disorder was found in 29% of the pathological gamblers 84% of whom scored either low on SD and high on impulsivity or had a more dishonest behaviour. Two-thirds of pathological gamblers showed immature character with or without high HA in temperament. The other third showed normal-character extravagant behaviour (86%), high impulsivity (36%) and less responsibility (50%) being the most common personality traits. Conclusion HA and NS might be trait-like characteristics in PG.     

Missouri Casino Self-Excluders: Distributions Across Time and Space

According to public health research, exposure to casinos is a risk factor for disordered gambling. Consequently, casino self-exclusion programs, which provide gamblers with the opportunity to voluntarily seek limits on their access to gambling venues, can serve as a barometer of the concentration of disordered gambling in an area. This study reports on the distribution, both temporally and geographically, of 6,599 people who applied to exclude themselves from Missouri casinos between November, 1996 and February, 2004. Analyses used Microsoft MapPoint to plot the location of casinos and self-excluders (SEs) across Missouri and its constituent counties. These regional exposure analyses showed that the Western region around Kansas City is an epicenter of disordered gambling as, to a lesser extent, is the Eastern region around St. Louis. The annual number of SE enrollments increased during the first few years of the Missouri self-exclusion program and then leveled off during the later years. These findings have important implications for public health and the development of public health interventions for disordered gamblers.     

Treatment Goal Selection for Female Pathological Gambling: A Comparison of Abstinence and Controlled Gambling

The current study was an exploratory investigation of the selection of controlled gambling as a goal of treatment for female pathological gambling. Specifically, it aimed to explore: 1) the popularity of controlled gambling as a goal of treatment; 2) the reasons pathological gamblers select abstinence and controlled gambling as goals of treatment; and 3) the characteristics of pathological gamblers attracted to abstinence and controlled gambling. The sample comprised 85 female pathological gamblers attending a cognitive-behavioural treatment program for pathological gambling. The selection of controlled gambling by one-third (34%) of the sample suggests that, at least in the Australian context, controlled gambling is a relatively popular goal of treatment for female pathological gamblers. In this study, the only differences between treatment-seeking female pathological gamblers selecting abstinence and controlled gambling were that those selecting controlled gambling were older and were less likely to endorse the belief that problematic gambling is a disease or affliction that can only be overcome by lifelong abstinence. Further research investigating the characteristics of pathological gamblers associated with controlled gambling as both a goal and outcome of treatment is required in order to ensure that treatment-seeking pathological gamblers can make an informed decision regarding their goal selection.