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.     

Exploring the Hidden Nature of Gambling Problems among People Who Are Homeless

Abstract

Although people with gambling problems are now recognised to be among those groups of people at increased risk of homelessness, little research has explored their experiences. This qualitative interpretive study explored the experiences of people who were homeless and had gambling problems, and the housing and gambling service providers assisting them. In-depth interviews were conducted with 17 service users and 18 service providers. A key finding was that gambling problems among those experiencing homelessness are often hidden; few people presented to housing services admitting to gambling problems. Shame, stigma, and identity issues were described as the main reasons service users did not disclose their gambling activities. The research highlighted that the relationship between service providers and service users was infused with power imbalances and shaped by social discourses and policies that demand self-responsibility and hinder information sharing between service providers and service users.     

The Public Stigma of Problem Gambling: Its Nature and Relative Intensity Compared to Other Health Conditions

Problem gambling attracts considerable public stigma, with deleterious effects on mental health and use of healthcare services amongst those affected. However, no research has examined the extent of stigma towards problem gambling within the general population. This study aimed to examine the stigma-related dimensions of problem gambling as perceived by the general public compared to other health conditions, and determine whether the publicly perceived dimensions of problem gambling predict its stigmatisation. A sample of 2000 Australian adults was surveyed, weighted to be representative of the state population by gender, age and location. Based on vignettes, the online survey measured perceived origin, peril, concealability, course and disruptiveness of problem gambling and four other health conditions, and desired social distance from each. Problem gambling was perceived as caused mainly by stressful life circumstances, and highly disruptive, recoverable and noticeable, but not particularly perilous. Respondents stigmatised problem gambling more than sub-clinical distress and recreational gambling, but less than alcohol use disorder and schizophrenia. Predictors of stronger stigma towards problem gambling were perceptions it is caused by bad character, is perilous, non-recoverable, disruptive and noticeable, but not due to stressful life circumstances, genetic/inherited problem, or chemical imbalance in the brain. This new foundational knowledge can advance understanding and reduction of problem gambling stigma through countering inaccurate perceptions that problem gambling is caused by bad character, that people with gambling problems are likely to be violent to other people, and that people cannot recover from problem gambling.     

God,family and money: Pacific people and gambling in New Zealand

Pacific people living in New Zealand are less likely to participate in gambling activities than the general population but those who do gamble are at greater risk of being problem gamblers. This difference remains when socio-economic variables are controlled for. To date, little research has investigated the reasons underlying these differences. The present exploratory study investigated Pacific people's thoughts about gambling through a series of focus groups involving 97 participants, including Pacific gamblers, non-gamblers, gambling venue workers, gambling treatment providers and church leaders. The results suggest that some Pacific people draw a distinction between ‘community’ and ‘commercial’ types of gambling, that gambling is understood by some to be an easy way in which to make money, and also that familial and church obligations can motivate gambling behaviour. These findings inform possible unique features of gambling in Pacific cultures in New Zealand and internationally. Moreover, together with the research approach the results inform further research on Pacific peoples' relationship with gambling, as well as those of other cultural groups.     

Family Influences on Adolescent Gambling Behavior: A Review of the Literature

Gambling, and gambling related problems, are recognized as an emerging health issue among adolescents. Adolescent gambling is associated with numerous individual, social, and family characteristics. This paper provides a review of 21 empirical studies published between 1997 and 2008 that examine family influences on adolescent gambling behavior. Family influences on gambling behavior are conceptualized in the following five domains: (1) family sociodemographic factors, (2) general family climate, (3) family members’ attitudes and behaviors, (4) parenting practices, and (5) family relationship characteristics. Based on the review of extant literature, there is empirical evidence that family characteristics are associated with adolescent gambling and further examination of family system influences on gambling behavior is needed. Gaps in the current literature and recommendations for future research are discussed to help inform the study of family influences on adolescent gambling behavior.     

Electronic Gaming Machine Gambling: Measuring Motivation

Electronic gambling machines (EGMs) are known to be a particularly risky form of gambling (Petry. Addiction 98(5):645–655, 2003). It is vital that researchers and clinicians are aware of factors which could lead to people having problems with this form. Gambling motivation is one such factor. This study developed a measure of EGM gambling motivations based on the results of qualitative research conducted with EGM problem gamblers and experienced counsellors (Thomas et al. Int J Mental Health Addiction 7:97–107, 2009). A community based sample of 232 females (M = 29.60 years of age, SD = 15.41 years) and 123 males (M = 29.64 years of age, SD = 12.29 years) participated. Exploratory factor analysis extracted three motivational factors indicating people gambled on EGMs to escape, for its accessibility and for the social environment. Gambling to escape and for its accessibility had substantial positive correlations with frequency of EGM gambling and gambling problems. Social environment correlated less well with these indicators of excessive gambling. Correlations between factors suggested the accessible, social experience offered by EGM venues increases their appeal as a means of escape. The new subscales were internally consistent and demonstrated good evidence of validity. This new measure will facilitate future investigations into the relationships between gambling motivations, other aetiological factors and EGM problem gambling.     

Behavioural profiling of problem gamblers: a summary and review

In many countries, there is increasing interest in early intervention strategies to assist people who are experiencing gambling-related problems. Central to these discussions is whether it is possible to identify problem gambling and/or risky behaviour in situ before gamblers formally seek assistance. This paper provides a review and critique of the small amount of published literature relating specifically to behavioural indicators and their practical application. It concludes that, while there is general agreement concerning the range of indicators that could be used, the process of identification remains difficult in practice. Multiple indicators are usually required to make reliable identifications; the nature of indicators will vary depending on the mode of gambling (land-based vs online), and venue staff employees usually have insufficient opportunity to obtain enough information to make judgments. The potential value of combining behavioural information with electronically monitored gambling data is discussed as a possible future strategy for enhancing the effectiveness of identification processes.     

Prevalence of Adolescent Problem Gambling: A Systematic Review of Recent Research

Previous research has shown that gambling is a popular activity among adolescents. Following a rapid expansion of legalized gambling opportunities and the emergence of new forms of gambling, many researchers have carried out studies on adolescent gambling and problem gambling. The present paper reviews studies that have been conducted worldwide since 2000, and then presents a more detailed picture of adolescent gambling research in Europe, by providing a country-by country analysis. After an extensive search on academic databases and following an exclusion process, 44 studies were identified. The findings showed that 0.2–12.3 % of youth meet criteria for problem gambling, notwithstanding differences among assessment instruments, cut-offs, and timeframes. However, despite this variability, several demographic characteristics were associated with adolescent gambling involvement and problem gambling. It is concluded that a small but significant minority of adolescents have gambling-related problems. Such findings will hopefully encourage more research into youth gambling to further understand the determinants of this phenomenon.     

Gambling Disorder in Veterans: A Review of the Literature and Implications for Future Research

To review the scientific literature examining gambling behavior in military veterans in order to summarize factors associated with gambling behavior in this population. Database searches were employed to identify articles specifically examining gambling behavior in military veterans. Cumulative search results identified 52 articles (1983–2017) examining gambling behavior in veteran populations. Articles generally fell into one or more of the following categories: prevalence, psychological profiles and psychiatric comorbidities, treatment evaluations, measurement, and genetic contributions to gambling disorder. Results from reviewed articles are presented and implications for future research discussed. Research to date has provided an excellent foundation to inform potential screening, intervention and research activities going forward. The authors suggest that a public health approach to future research endeavors would strengthen the evidence base regarding gambling in veteran populations and better inform strategies for screening, prevention and treatment.     

The New Zealand national survey of problem and pathological gambling

In New Zealand, awareness of gambling-related problems has increased in association with the legalization of new forms of gambling. This paper presents the methods and selected results from a national survey of gambling and problem gambling completed in New Zealand in 1991. While the primary aim of the study was to determine the extent of problem gambling in New Zealand, the study included a second phase intended to assess the validity and reliability of the widely-used South Oaks Gambling Screen as well as to examine other aspects of problematic involvement in gambling. The results of the two-phase study in New Zealand show that problem gamblers in different countries are remarkably similar in demographic terms as well as with regard to other risk factors associated with problematic gambling involvement. The New Zealand study of problem gambling points the way toward important research topics that will require further exploration in the future.This research was funded by the New Zealand Department of Internal Affairs and by the US National Institute of Mental Health (MH-44295).     

Demographic,Behavioural and Normative Risk Factors for Gambling Problems Amongst Sports Bettors

Sports betting is growing exponentially, is heavily marketed and successfully targets young adult males. Associated gambling problems are increasing. Therefore, understanding risk factors for problem gambling amongst sports bettors is an increasingly important area of research to inform the appropriate design and targeting of public health and treatment interventions. This study aimed to identify demographic, behavioural and normative risk factors for gambling problems amongst sports bettors. An online survey of 639 Australian sports bettors using online, telephone and retail betting channels was conducted. Results indicated that vulnerable sports bettors for higher risk gambling are those who are young, male, single, educated, and employed full-time or a full-time student. Risk of problem gambling was also found to increase with greater frequency and expenditure on sports betting, greater diversity of gambling involvement, and with more impulsive responses to betting opportunities, including in-play live action betting. Normative influences from media advertising and from significant others were also associated with greater problem gambling risk. The results of this study can inform a suite of intervention, protection and treatment initiatives targeted especially at young male adults and adolescents that can help to limit the harm from this gambling form.     

A Preliminary, Qualitative Exploration of the Influences Associated with Drop-Out from Cognitive-Behavioural Therapy for Problem Gambling: An Australian Perspective

It has been estimated that 80% of Australians engage in some form of gambling, with approximately 115,000 Australians experiencing severe problems (Productivity Commission 2010). Very few people with problem gambling seek help and, of those who do, large numbers drop-out of therapy before completing their program. To gain insights into these problems, participants who had either completed or withdrawn prematurely from an individual CBT-based problem gambling treatment program were interviewed to examine factors predictive of premature withdrawal from therapy as well as people??s ??readiness?? for change. The results indicated that there might be some early indicators of risk for early withdrawal. These included: gambling for pleasure or social interaction; non-compliance with homework tasks; gambling as a strategy to avoid personal issues or dysphoric mood; high levels of guilt and shame; and a lack of readiness for change. The study further showed that application of the term ??drop-out?? to some clients may be an unnecessarily negative label in that a number appear to have been able to reduce their gambling urges even after a short exposure to therapy.     

A Case of Mistaken Identity? A Comparison of Professional and Amateur Problem Gamblers

Professional gamblers are more likely than amateur gamblers to meet criteria for problem gambling but minimal research has examined their gambling behavior and its consequences. This study compared gambling behavior, problem gambling symptoms, related harms, recognition, and help-seeking among problem semi/professional gamblers (PPGs/PSPGs) and problem amateur gamblers (PAGs). Surveys completed by 57 self-identified professional gamblers, 311 semi-professional gamblers and 4226 amateur gamblers were analysed. PPGs/PSPGs were significantly more likely than PAGs to be male, younger, never married, speak a language other than English at home, and have higher psychological distress, compared to PAGs. PPGs/PSPGs were more likely to gamble more frequently on many skills-based forms, but most also participated in several chance-based forms. PPGs’/PSPGs’ most common problematic gambling form was electronic gaming machines and they were more likely to have problems with sports betting than PAGs. Most PPGs/PSPGs reported coming out behind on all gambling forms over the previous year. PPGs/PSPGs were more likely than PAGs to report chasing losses and numerous detrimental financial gambling consequences. This group’s self-identification as PPGs/PSPGs is clearly inaccurate and perhaps a means to avoid stigma, elevate status and support problem denial. PPGs/PSPGs may represent an extreme example of gamblers with erroneous cognitions and beliefs who lack the required discipline and skill to be successful professional gamblers. The findings identify a group of problem gamblers who may benefit from interventions to dispel their mistaken self-identity, and emphasize the need for more rigorous confirmation of professional gambler status in future research.     

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.     

Lessons from the Grey Area: A Closer Inspection of At-risk Gamblers

The study takes a closer look at at-risk gamblers, with the objective to see how they differ from no-risk gamblers. The data comes from a national gambling survey in 2002, and the age group is 15–74 years. The sample consists of 4188 current gamblers with no current gambling problems or pathology. The analysis includes cross-tabulations and a logistic regression. The results show that at-risk gamblers differed substantially from no-risk gamblers in terms of demographic characteristics, gambling behaviour and the presence of other assumed risk factors. Demographic segments with a higher risk of falling into the at-risk group are men, young people, divorced or single people, and non-western immigrants. Furthermore, gambling problems in the family, beginners luck and misconceptions about winning chances significantly increased the odds for at-risk gambling. The study concludes that at-risk gamblers deserve more attention from research, that their similarity with problem gamblers increases the likelihood that many of them will eventually develop a gambling problem, and that their tendency to be superstitious about winning chances might be exploited in preventive work.     

Measuring Gambling Problems Among Adolescents: Current Status and Future Directions

While there is a growing body of research concerning risk, protective and psycho-social correlates associated with youth gambling and problem gambling, our conceptualisation and measurement of adolescent problem gambling has not evolved to the same extent. This paper highlights our current understanding and measurement of adolescent problem gambling while drawing attention to recent research findings suggesting the need for the refinement of current measures and for the development of a new gold standard instrument. Recommendations and consideration for future directions are provided.     

Problem Gambling in Non-English Speaking Background Communities in Queensland,Australia: A Qualitative Exploration

This paper provides an overview of qualitative research into problem gambling among non-English speaking background (NESB) communities in Queensland, Australia. The focus for this pilot study was the Chinese, Greek and Vietnamese communities. Using qualitative methodologies, this community-based research explored the motivations for gambling, and the impacts of problem gambling upon individuals and communities. Findings indicate that problem gambling is evident in each of the communities of study, but the issue is characterised by a pervasive sense of denial. Gambling is an issue of enormous shame and stigma, not only for the problem gambler but their entire family. As a result, most problem gamblers do not seek professional help but try to resolve the problem themselves or within the family unit. Research findings indicate that service access could be increased through a range of strategies including the provision of culturally appropriate community education and gambling help services, partnerships between NESB communities, gambling help services and community workers, and the development and implementation of preventative strategies.     

Problem Gambling Among International and Domestic University Students in Australia: Who is at Risk?

Young people are a high risk group for gambling problems and university (college) students fall into that category. Given the high accessibility of gambling in Australia and its association with entertainment, students from overseas countries, particularly those where gambling is restricted or illegal, may be particularly vulnerable. This study examines problem gambling and its correlates among international and domestic university students using a sample of 836 domestic students (286 males; 546 females); and 764 international students (369 males; 396 females) at three Australian universities. Our findings indicate that although most students gamble infrequently, around 5 % of students are problem gamblers, a proportion higher than that in the general adult population. Popular gambling choices include games known to be associated with risk (cards, horse races, sports betting, casino games, and gaming machines) as well as lotto/scratch tickets. Males are more likely to be problem gamblers than females, and almost 10 % of male international students could be classified as problem gamblers. Hierarchical regression analysis showed that male gender, international student status, financial stress, negative affect and frequency of gambling on sports, horses/dogs, table games, casino gaming machines, internet casino games and bingo all significantly predicted problem gambling. Results from this study could inform gambling-education programs in universities as they indicate which groups are more vulnerable and specify which games pose more risk of problem gambling.     

How does the stigma of problem gambling influence help-seeking,treatment and recovery? a view from the counselling sector

Problem gambling attracts considerable public stigma and can cause significant self-stigma. However, little research has investigated the role of stigma during treatment-assisted recovery from problem gambling. This study aimed to examine gambling counsellors’ perspectives on whether and how the stigma associated with problem gambling influences problem acknowledgement, help-seeking, treatment and recovery. In-depth interviews with nine gambling counsellors from Victoria, Australia, were analysed to extract shared meanings of experiences using interpretative phenomenological analysis. Counsellors indicated that the burden of problem gambling is typically increased by the addition of stigma and its impacts. This stigma is created and maintained by a lack of public understanding about problem gambling and its causes, and internalization of self-stigmatizing beliefs, leading to delayed help-seeking, anxiety about attending treatment, concerns about counsellor attitudes, and fear of relapse. Counsellors maintained that, before effective gambling treatment could occur, they needed to help clients overcome their self-stigmatizing beliefs to establish confidence and trust in the counsellor, restore self-esteem, enhance stigma coping skills and foster a belief that recovery is possible. Harnessing support from significant others and preparing clients for relapse were also important inclusions to lower stigma. Addressing stigma early in treatment can help to improve treatment adherence and recovery.     

Lottery play and problem gambling

This study sought to determine if lottery play along with other possible causes engenders problem gambling. Problem gambling was defined as a progression and measured by three scales: Gambling behavior, loss of control over gambling and gambling consequences. Possible causes of problem gambling included lottery play, personality traits, exposure to gambling, leisure pursuits, marital status, residence, and other background characteristics of respondents. Respondents are a stratified random sample of adult residents of Iowa contacted by telephone in May–June, 1989. It was found that lottery play is a predictor of gambling behavior, as well as loss of control and gambling consequences when previous stages of problem gambling were deleted from the analysis as predictor variables. Other predictors of the latter stages of problem gambling include its earlier stages, as well as personality traits and various background characteristics of respondents. The relevance of the findings for theory and future research on gambling are discussed.This research was partially supported by the Iowa Department of Human Services. We also wish to acknowledge the helpful comments of reviewers from this journal.