Gambling Participation and Problems Among Employees at a University Health Center

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

Gambling decisions: an early intervention program for problem gamblers

An implementation and one-year follow-up of the Gambling Decisions program attempted to answer several important questions. First, is controlled gambling a viable treatment option for some gamblers? Can earlier stage problem gamblers be separated for treatment from those with more severe problems? Finally, would problem gamblers utilize a community health agency for treatment of their excessive gambling? A pretest/posttest design was chosen where the efficacy of the program was assessed using repeated measures ANOVA analysis. Results showed that an average loss of $608 over a 4-week period was reduced to $113 immediately after the 6-week program and to a loss of $73 at 12 months. The average number of hours spent gambling per 4 weeks was significantly reduced from 23.5 at pretest to 6.5 at the 12 month posttest. Significant decreases were also observed in the number of days per week that clients gambled, and clients reported significant reductions in everyday life problems related to gambling after completing the program.     

Clinical Care of Gambling Disorders: Training, Experience, and Competence Among VHA Psychologists

Problem gambling is a common, highly destructive disorder which is often overlooked by clinicians. Levels of clinical training, clinical experience, and professional competence for providing clinical services for problem gambling were examined in a survey of 181 clinical psychologists working in the Veterans Healthcare Administration (VHA). The results suggest that the majority of clinical psychologists have little or no formal training and little or no past or current clinical experience in the treatment of disordered gambling, nor do they see themselves as competent to evaluate or treat patients with disordered gambling. Most have not referred patients for treatment of problem gambling and do not know of a competent provider to whom they can refer. There is an identifiable subgroup, representing 9% of respondents, who do have more training, provide services, and see themselves as competent to provide care for patients with problem gambling. The amount of formal training is positively correlated with care provided and self-ratings of competence. Despite the lack of training and experience, most respondents expressed interest in receiving additional training. These data suggest that to improve rates of diagnosis and treatment of patients with problem gambling in mental health settings, additional training needs to be made available for mental health providers as a group, with specialized training for clinicians interested in specializing in this area.     

Life Skills,Mathematical Reasoning and Critical Thinking: A Curriculum for the Prevention of Problem Gambling

Previous studies have shown that youth are two to three times more likely than adults to report gambling related problems. This paper reports on the development and pilot evaluation of a school-based problem gambling prevention curriculum. The prevention program focused on problem gambling awareness and self-monitoring skills, coping skills, and knowledge of the nature of random events. The results of a controlled experiment evaluating the students learning from the program are reported. We found significant improvement in the students' knowledge of random events, knowledge of problem gambling awareness and self-monitoring, and knowledge of coping skills. The results suggest that knowledge based material on random events, problem gambling awareness and self-monitoring skills, and coping skills can be taught. Future development of the curriculum will focus on content to expand the students' coping skill options.     

Problem gambling,anxiety and poverty: an examination of the relationship between poor mental health and gambling problems across socio-economic status

Socio-economic status has been shown to be significantly related to both problem gambling and mental health problems. Additionally, forms of psychopathology such as mood and anxiety disorders have been shown to correlate with problem gambling across a variety of settings. However, relatively little research has been conducted examining whether the connection between mood and anxiety disorders and problem gambling is consistent across different levels of socio-economic status. This study examines gambling-related problems among a representative sample of Canadian adults using the 2008 Canadian Community Health Survey (N = 28,271). Generalized linear modelling is used to analyze the data. A moderation effect is found that shows the relationship between anxiety disorders and problem gambling severity varies significantly across socio-economic status. This study shows that social setting has an important influence on the assumed relationship between psychopathology and gambling problems that is downplayed in current problem gambling research. A discussion of the need for greater inclusion of socio-economic context when making assumptions about the connections between problem gambling and psychiatric disorders is made in light of the responsibilities of gambling providers and regulators.     

Factors Associated with Gamblers: A Population-based Cross-sectional Study of South Australian Adults

Objective To determine, using a random telephone survey, the prevalence of various gambling activities among South Australian adults, the prevalence of adult problem gamblers using the South Oaks Gambling Screen (SOGS) instrument, and to examine the problem gamblers by demographic and health-related risk factors.Method A random representative sample of South Australian adults selected from the Electronic White Pages. Overall, 6045 interviews were conducted (73.1% response rate) using Computer Assisted Telephone Interviewing (CATI) technology.Results Overall, 75.6% (95% CI: 74.5–76.7) of respondents had participated in at least one gambling activity during the last 12 months and 2.0% (95% CI: 1.7–2.4) were identified to be problem gamblers. A wide range of factors was associated with problem gambling at a univariate level, when compared to frequent gamblers. The logistic regression analysis highlighted that problem gamblers were more likely to speak a language other than English, be employed part time and a smoker when compared to frequent gamblers. Problem gamblers were also more likely to have a mental health condition (according to the Kessler 10), have had suicidal thoughts and know of services for gambling problems.Conclusion There is a wide range of characteristics associated with problem gambling in South Australia. All of these factors need addressing during policy development to assist problem gamblers.     

Legal gambling availability and problem gambling among adolescents and young adults

A national US telephone survey was conducted with 2274 respondents aged 14–21. The number of types of legal gambling operating in the respondent's state was positively related to the odds of lifetime gambling, current gambling, current frequent gambling and current problem gambling. For respondents aged 18–21, odds of current problem gambling, as opposed to never gambling, increased 39% for each additional type of legal gambling. The number of types of gambling in which a respondent was old enough to participate legally had a positive relationship to gambling involvement, including problem gambling. Being old enough to participate in specific forms of gambling was positively related to the frequency of playing those specific types. It was concluded that a greater number of types of legal gambling, as well as being old enough to legally play a greater number of types of gambling, is associated with a greater likelihood of problem gambling.     

Juvenile Gambling in North America: An Analysis of Long Term Trends and Future Prospects

Long term trends, based on findings from twenty independent prevalence studies surveying middle and high school youth in North America, suggest that within the past year two out of three legally underage youth have gambled for money. In the United States and Canada as many as 15.3 million 12–17 year olds have been gambling with or without adult awareness or approval, and 2.2 million of these are experiencing serious gambling-related problems. Lottery play dominates legalized forms of gambling among juveniles in both the United States and Canada. Trends between 1984–1999 indicate a substantial increase in the proportion of juveniles who report gambling within the past year, and a parallel increase in the proportion of juveniles reporting serious gambling-related problems. Yet, there continues to be little public awareness or concern about the extent, or the potential hazards associated with juvenile gambling. A composite profile of juveniles reporting numerous gambling problems is contrasted with their peers who reported few or none. Future prospects concerning this growing problem are offered.     

Parents' Attitudes, Knowledge, and Behavior Toward Youth Gambling: A Five-Year Follow-up

This study compares the attitudes, knowledge, and behavior of parents of 5- to 17-year-old children regarding youth gambling. This information was obtained through two telephone surveys conducted in 1995, and 5 years later in 2000, in the Québec City area. Survey 1, in 1995, was conducted on 279 respondents, while survey 2, in 2000, was carried out with 213 respondents. Results showed a number of changes in parents' attitudes, behavior, and knowledge concerning youth gambling: For example, parents' perception of the age of onset of gambling behavior had improved slightly at the end of the 5-year period. Furthermore, parents were more satisfied with government limitation of access to gambling, and more accurately informed about legal aspects of the sale of lottery tickets. However, the percentage of parents who failed to associate youth gambling with some of its correlates (arcade attendance, parental gambling problems, and friendship with gamblers) increased from 1995 to year 2000. The improvements that were observed suggested that parents had benefited from media-transmitted information during this period. However, the deterioration of some parental attitudes, and the stability of other variables, suggest that it is still important to educate parents about youth gambling, and to design interventions adapted to parents' needs.     

AN EXPLORATION OF THE THERAPEUTIC RELATIONSHIP AND COUNSELLING OUTCOMES IN A PROBLEM GAMBLING COUNSELLING SERVICE

This study examined the relationship between a number of counselling process variables thought to influence counselling outcomes in a sample of 150 clients undertaking short‐term counselling in the state‐wide government funded Gambler's Help problem gambling counselling services in Victoria, Australia. Factors measured included psychosocial well‐being of clients prior to and after counselling, client readiness to change, self‐reported gambling activity levels before and after counselling, self‐assessment of current gambling behaviour, strength of therapeutic alliance, self‐reported counselling outcomes achieved in the area of symptoms, life matters, and related problems and a measure of client satisfaction with the service. The therapeutic alliance was found to have the strongest predictive power with respect to the level of problem resolution achieved by clients across all but one of the problem areas. The implications of these findings for clinical social work practice and education of practitioners are noted.     

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.     

Perceived stigma and self-stigma of problem gambling: perspectives of people with gambling problems

Minimal research has investigated the stigma associated with problem gambling, despite its major hindrance to help-seeking and recovery. This study explored perceived stigma and self-stigma to examine stigmatizing beliefs held, how they may be internalized, coping mechanisms, and effects on help-seeking. In-depth interviews with 44 people experiencing gambling problems were analysed using interpretive phenomenology. Results revealed an overwhelming perception that problem gambling attracts acute public stigma and is publicly viewed as caused by personal failings. Participants had serious concerns about being viewed as ‘a problem gambler’, fearing demeaning stereotypes, social rejection, hostile responses and devaluing behaviours. Many participants internalized perceived stigma as self-stigma, with deleterious reported effects on self-esteem, self-efficacy, perceived social worth, and mental and physical health. Deep shame was a near universal emotion and exacerbated by relapse. Secrecy was the main coping mechanism used, with perceived and self-stigma found to act as major barriers to disclosure and help-seeking. The findings can inform the development of a valid understanding and conceptualization of problem gambling stigma. This is a prerequisite for effective stigma-reduction strategies to reduce public stigma and discrimination, and to lower perceived and self-stigma and increase the use of treatment services and other interventions by people with gambling problems.     

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.     

Perceptions of the Extent of Problem Gambling Within New Casino Communities

Several recent studies using objective measures have found that the rate of pathological gambling in the U.S. is less than 5%. To determine the general population's perception of the prevalence of pathological gambling, a survey was conducted in seven communities where casinos have recently opened. Of the 1631 respondents who provided an estimate, the mean response was that 16% of the community residents were problem gamblers, more than three times the rate found by studies using specific diagnostic criteria. A regression equation found several demographic and attitudinal items are associated with higher prevalence estimates. In addition, the data support a close to home hypothesis that respondents who have relatives who have experienced problems with gambling will tend to perceive higher rates of problem gambling in the community.     

Gambling and the Health of the Public: Adopting a Public Health Perspective

During the last decade there has been an unprecedented expansion of legalized gambling throughout North America. Three primary forces appear to be motivating this growth: (1) the desire of governments to identify new sources of revenue without invoking new or higher taxes; (2) tourism entrepreneurs developing new destinations for entertainment and leisure; and (3) the rise of new technologies and forms of gambling (e.g., video lottery terminals, powerball mega-lotteries, and computer offshore gambling). Associated with this phenomenon, there has been an increase in the prevalence of problem and pathological gambling among the general adult population, as well as a sustained high level of gambling-related problems among youth. To date there has been little dialogue within the public health sector in particular, or among health care practitioners in general, about the potential health impact of gambling or gambling-related problems. This article encourages the adoption of a public health perspective towards gambling. More specifically, this discussion has four primary objectives:1. Create awareness among health professionals about gambling, its rapid expansion and its relationship with the health care system;2. Place gambling within a public health framework by examining it from several perspectives, including population health, human ecology and addictive behaviors;3. Outline the major public health issues about how gambling can affect individuals, families and communities;4. Propose an agenda for strengthening policy, prevention and treatment practices through greater public health involvement, using the framework of The Ottawa Charter for Health Promotion as a guide.By understanding gambling and its potential impacts on the public's health, policy makers and health practitioners can minimize gambling's negative impacts and appreciate its potential benefits.     

Thoughts and acts of self-harm,and suicidal ideation,in online gamblers

Gambling problems have been linked to suicidal ideation and enhanced risk of suicide attempts. However, we know very little about the factors associated with either thoughts or acts of self-harm amongst people who gamble. A web-based study of 4125 online gamblers (79% males; mean age 35.5 years), analysed using hierarchical multiple regression, revealed that self-reported non-gambling-related self-harm was negatively related to age and marital status, and positively related to problematic alcohol use. Self-reported acts of self-harm both related and unrelated to gambling were associated with drug misuse. Thoughts and acts of gambling-related self-harm were associated with problem gambling, gambling involvement and parental problem gambling. All types of self-harm were associated with mood disorder symptoms, unemployment and certain gambling motivations. When tailoring assessment and interventions for individuals at risk for gambling-related deliberate self-harm, it is important to recognize that contributory factors may include some that differ from those for deliberate self-harm in general, and that there is potential value in evaluating gambling involvement and motivations, and history of parental 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.     

Daily and season-long fantasy sports participation and gambling-related problems among a sample of college students at three universities

Traditionally, fantasy sports have been played in season-long leagues, but recently daily fantasy sports (DFS) have emerged, allowing participants to play fantasy contests over shorter periods of time. Although participating in fantasy sports contests with entry fees or deposits could be considered a form of gambling, very few studies have examined associations between fantasy sport participation and gambling-related problems. Using a 2016 sample of college students (N = 941) at three institutions, this study examined associations between fantasy sports participation (season-long and DFS) and (1) gambling, (2) gambling frequency, and (3) endorsing DSM-5 gambling disorder (GD) criteria. The study found that engagement with fantasy sports and paying to play increased the likelihood of gambling and more frequent gambling. Respondents who paid an entry fee/deposit to play fantasy sports gambled more frequently than those who did not, and respondents who participated in DFS endorsed more DSM-5 GD criteria than those who did not. Because of the association found between DFS play and gambling-related problems in some participants, the study suggests that mental health professionals who treat clients with gambling problems be cognizant of DFS and that some clients might be experiencing problems with DFS.