Controlled Gambling for Pathological Gamblers

Despite its high prevalence, pathological gambling often remains untreated. It is estimated that only 10% of the pathological gamblers identified in prevalence studies will enter treatment. Within this small proportion, a high percentage will drop out. Despite the facts that some researchers argue against abstinence as the unique treatment goal and that regaining control appears to be possible for some pathological gamblers, abstinence has been the only treatment goal in most problem gambling interventions thus far. This paper examines the avenue of controlled gambling embedded in a harm reduction context as a viable solution for some pathological gamblers.     

Obsessive-Compulsive Features in Pathological Lottery and Scratch-Ticket Gamblers

The results of this study support the notion that pathological gamblers drawn from the community would score higher on all three scores from the YBOCS than light gamblers. Consistent with hypotheses, pathological gamblers (lottery and scratch ticket) reported more obsessions, compulsions, and avoidance behavior than the light gamblers, and also reported having more urges to engage in injurious behaviors to themselves and others. These findings provide evidence that pathological gambling falls in a spectrum or family of disorders which have obsessive-compulsive disorder at its core. These findings support McElroy, Hudson, Philips, et al.'s (1993) suggestions of similarities between OCD and Impulse Control Disorders, and extend Blaszczynski (1999) findings of overlap between pathological gamblers and OCD in a treatment population. Heavy gamblers also reported significantly more hoarding symptoms and compulsive buying than light gamblers. More research in this area may show further evidence of a spectrum of disorders with obsessive compulsive disorder at its core, and show further links between impulse control disorders (such as pathological gambling) and OCD.     

Near Wins Prolong Gambling on a Video Lottery Terminal

The purpose of the present study was to evaluate whether near wins can prolong gambling activity on a video lottery terminal. In a three-reel game, near wins were operationally defined as two identical symbols followed by a third different symbol. Players in an experimental condition were exposed to 27% near wins in a series of continuous losses, whereas players in a control group were exposed to none. Participants played as long as they wished, and received real money for their wins. The results showed that players in the near win condition played 33% more games than did the control group. The results of this study suggest that near wins can be added to the list of factors that may motivate people to gamble despite the probability of monetary loss.     

Narrowing of Attention and Dissociation in Pathological Video Lottery Gamblers

The phenomena of attention and dissociation were investigated in pathological and occasional video lottery (VLT) gamblers. Twelve problem VLT gamblers [mean age 41.3; 6 male, 6 female; South Oaks Gambling Screen (SOGS; Lesieur & Blume, 1987) scores 5] were compared to a group of 11 occasional VLT gamblers, (mean age 31.9; 4 male, 7 female; SOGS scores < 5). Pathological gamblers were slower than occasional gamblers in reacting to irrelevant external light stimuli while playing on a demonstration video lottery terminal. They were significantly more likely to report more symptoms of general dissociation as measured by the Dissociative Experiences Scale (Bernstein & Putnam, 1986). The results suggest that pathological gamblers may experience a greater narrowing of attention than occasional gamblers when engaged in VLT play.     

Awareness Promotion About Excessive Gambling Among Video Lottery Retailers

This paper describes and evaluates “As luck would have it,” an awareness program completed by retailers in Quebec Province. This program, which is presented as a two-hour awareness promotion workshop, aimed to inform retailers about excessive gambling. More specifically, it provided answers to the following questions: (1) What is chance and randomness? (2) Is there a link between misunderstanding the concept of chance and excessive gambling? (3) How does one recognise the symptoms of this disorder? (4) How should retailers intervene if they decide to do so? Results showed that retailers developed a better understanding of problem gambling, could recognise its main symptoms, felt more capable of coping with excessive gamblers, and of choosing the most appropriate moment to do so. In the follow-up phase, retailers who had attended the workshop reported that they approached a problem gambler significantly more often than the retailers who had not attended the workshop, and had discussed how to help problem gamblers significantly more often. The practical implications of these results are briefly discussed.     

Characteristics of Older Adult Problem Gamblers Calling a Gambling Helpline

Background Few investigations have characterized groups of older adults with gambling problems, and published reports are currently limited by small samples of older adult problem gamblers. Gambling helplines represent a widespread mechanism for assisting problem gamblers to move into treatment settings. Given data from older adult problem gamblers in treatment, we hypothesized that older as compared with younger adult problem gamblers calling a gambling helpline would be less likely to report gambling-related problems.Design and methods Logistic regression analyses were performed on data obtained from January 1, 2000 to December 31, 2001, inclusive, from callers with gambling problems (N = 1,084) contacting the Connecticut Council on Problem Gambling Helpline.Results Of the 1,018 phone calls used in the logistic regression analyses, 168 (16.5%) were from older adults and 850 (83.5%) from younger adults. Age-related differences were observed in demographic features, types and patterns of gambling reported as problematic, gambling-related problems and psychiatric symptoms, substance use problems, patterns of indebtedness, and family histories of addictive disorders. Older as compared with younger adult problem gamblers were more likely to report having lower incomes, longer durations of gambling, fewer types of problematic gambling, and problems with casino slot machine gambling and less likely to report gambling-related anxiety, family problems, illegal behaviors and arrests, drug problems, indebtedness to bookies or acquaintances, family histories of drug abuse, and problems with casino table gambling.Conclusions Older as compared with younger adult problem gamblers calling a gambling helpline differ on many clinically relevant features. The findings suggest the need for improved and unique prevention and treatment strategies for older adults with gambling problems.     

Manipulations of the Features of Standard Video Lottery Terminal (VLT) Games: Effects in Pathological and Non-Pathological Gamblers

The present study was conducted to identify game parameters that would reduce the risk of abuse of video lottery terminals (VLTs) by pathological gamblers, while exerting minimal effects on the behavior of non-pathological gamblers. Three manipulations of standard VLT game features were explored. Participants were exposed to: a counter which displayed a running total of money spent; a VLT spinning reels game where participants could no longer stop the reels by touching the screen; and sensory feature manipulations. In control conditions, participants were exposed to standard settings for either a spinning reels or a video poker game. Dependent variables were self-ratings of reactions to each set of parameters. A set of 2(3) × 2 × 2 (game manipulation [experimental condition(s) vs. control condition] × game [spinning reels vs. video poker] × gambler status [pathological vs. non-pathological]) repeated measures ANOVAs were conducted on all dependent variables. The findings suggest that the sensory manipulations (i.e., fast speed/sound or slow speed/no sound manipulations) produced the most robust reaction differences. Before advocating harm reduction policies such as lowering sensory features of VLT games to reduce potential harm to pathological gamblers, it is important to replicate findings in a more naturalistic setting, such as a real bar.     

Pre/Early Adolescent Onset of Gambling and Psychosocial Problems in Treatment-Seeking Pathological Gamblers

This study examined the association between pre- or early-adolescent onset of gambling and severity of gambling and psychosocial problems in treatment-seeking adult pathological gamblers. A total of 236 pathological gamblers entering outpatient treatment completed the South Oaks Gambling Screen (SOGS) and the Addiction Severity Index (ASI). Using a quartile split procedure, gamblers who began gambling during their pre- or early-adolescent years (mean age of 10.5 years; 1st quartile) were compared to gamblers who began gambling later in life (mean age of 23.0 years; 2nd to 4th quartiles). Compared to later onset gamblers, pre/early adolescent onset gamblers reported increased severity of psychiatric, family/social, and substance abuse problems on the ASI. They were more likely to report cognitive problems (trouble understanding, concentrating, or remembering), suicidal ideation, and a history of inpatient psychiatric treatment, and were less likely to be satisfied with their current living situation. Pre/early adolescent onset gamblers also reported earlier age of initiation of drinking, and were more likely to have received treatment for an alcohol use disorder, and to have used cannabis and cocaine in their lifetimes. Taken together, these data suggest that pre/early adolescent-onset of gambling may be a risk factor for later-life psychiatric, family/social, and substance abuse problems in treatment-seeking pathological gamblers.     

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.     

Gamblers Anonymous and Cognitive-Behavioral Therapies for Pathological Gamblers

Numerous types of treatments for pathological gambling have been described, but two of the most common are Gamblers Anonymous (GA) and cognitive-behavioral therapy. This paper describes some outcome data associated with the two approaches. It also reviews evidence suggesting that a combined intervention may enhance therapy engagement and reduce relapse rates.     

A Comparison of Horse-Race, Bingo, and Video Poker Gamblers in Brazilian Gambling Settings

In the present study Brazilian gamblers from different settings were compared on socio-demographic characteristics, gambling behavior, and use of drugs. The SOGS was administered to 171 subjects at bingo (BG), video poker (VP), and horse-racing clubs (HR) of São Paulo. BG concentrated most women, VP the youngest and single gamblers, and HR the lowest income subjects. More VP than HR or BG gamblers reported taking time off work to gamble, as well as returning another day to win back lost money. They also had a higher number of scorable responses on the SOGS. The differences observed suggest that VP gamblers bear a greater risk of developing a pathological gambling pattern. The authors suggest that measures should be taken aimed at the prevention of pathological gambling, particularly among the young population of video poker gamblers.     

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.     

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.     

Comparisons of Gambling and Alcohol Use Among College Students and Noncollege Young People in the United States

Abstract

Objective: Gambling and alcohol use were compared for college and noncollege young adults in the US population. Participants: Participants were 1,000 respondents aged 18 to 21. Methods: Data were analyzed from a representative household sample of US young people aged 14 to 21 years old. Telephone interviews were conducted between August 2005 and January 2007. Results: After taking into account gender, age, race/ethnicity, and socioeconomic status, college student status did not predict gambling, frequent gambling, or problem gambling. In contrast, being a college student was associated with higher levels of alcohol use and problem drinking. Being male was the strongest predictor of both problem gambling and problem drinking. Blacks were less likely than whites to drink heavily; yet they were more likely than whites to gamble heavily. Conclusion: Young males should be targeted for prevention and intervention efforts for both problem gambling and problem drinking regardless of college student status.     

Evaluation and Treatment of Pathological Gambling

The aim of this article was to describe a model for evaluating and implementing cognitive-behavioral treatment for pathological gambling. The model takes into account the fact that pathological gamblers form a heterogeneous group with varied biopsychosocial characteristics.     

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.     

Dopamine Genes and Pathological Gambling in Discordant Sib-Pairs

Pathological gambling (PG) is an impulse control disorder that has been considered as a behavioral addiction. Recent studies have suggested the involvement of the dopaminergic system in addictions and impulse control disorders and associations of dopamine receptor genes (DRD1, DRD2, and DRD4) and PG have been reported. In the present study, 140 sib-pairs discordant for the diagnosis of PG (70 males and 70 females on each group) were recruited through the Gambling Outpatient Unit at the Institute of Psychiatry, University of Sao Paulo and were assessed by trained psychiatrists. A family-based association design was chosen to prevent population stratification. All subjects were genotyped for dopamine receptor genes (DRD1 -800 T/C, DRD2 TaqIA RFLP, DRD3 Ser9Gly, DRD4 48bp exon III VNTR, DRD5 (CA) repeat) and the dopamine transporter gene (SCL6A3 40 bp VNTR). Our results suggest the association of PG with DRD1 -800 T/C allele T (P = .03).     

The Stubborn Logic of Regular Gamblers: Obstacles and Dilemmas in Cognitive Gambling Research

Cognitive studies into gambling behaviour have shown that many gamblers misinterpret the odds of gambling activities, hold false beliefs about skill and luck, and over-estimate their subjective chances of success. Accordingly, providing accurate information about gambling in venues, or on slot-machines, would appear to be a sensible way to enhance the 'safety' of gambling products. Unfortunately, such ideas for educating gamblers may be difficult to implement in practice because of limitations and conceptual dilemmas in the cognitive literature. Irrational beliefs about gambling may be difficult to falsify, are often highly idiosyncratic and context-bound, and may stem more from the selective misuse of information than from a lack of knowledge about gambling activities. Drawing evidence from recent research into gambling-related cognitions, this paper examines the key elements of irrational-belief systems, and how this work might usefully inform the design of future consumer information initiatives.     

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.     

Patterns of Autonomic Arousal in Imaginal Situations of Winning and Losing in Problem Gambling

AIMS: To examine changes in skin conductance level (SCL), for problem gamblers in response to personally relevant imaginal tasks, representing winning or losing. SETTING, DESIGN, PARTICIPANTS AND MEASUREMENTS: SCL and subjective arousal were compared for problem poker machine gamblers (n = 13) and a control group (n = 20). Participants were asked to describe a situation in which they had (a) won and (b) lost during a period of gambling. Before and during the task, recordings of SCL were taken. FINDINGS: There were significant differences between responses of problem and social gamblers. A significant interaction indicated that social gamblers became more aroused in reaction to winning than losing, whereas problem gamblers became equally aroused in response to both tasks. CONCLUSIONS: The results suggest that it may be responses to losing, rather than winning that are paramount to the development and maintenance of problem gambling.