On a Roll: The Process of Initiation and Cessation of Problem Gambling Among Adolescents

As gambling becomes more accessible and acceptable in society, problems associated with gambling and gaming have begun to affect ever increasing numbers of adolescents. Although restricted from most forms of gambling by law, many adolescents are finding a path into problem gambling. Some are becoming compulsive gamblers early in their gambling career, facing a future filled with consequences and problems. Understanding the pathway or process by which these adolescents become engaged in gambling behavior and how they can extricate themselves from this addictive behavior can enhance the efficiency and effectiveness of our interventions. This article offers a perspective on the initiation and cessation of compulsive gambling using the basic elements of the process of intentional behavior change outlined in the Stages of Change from the Transtheoretical Model. The process of initiation of a problematic behavior is similar to the process of modification or cessation of a problematic behavior in terms of these stages of change. With adolescents it is important to distinguish between the process of initiation, which has implications for prevention of gambling problems, and the process of cessation, which often necessitates the assistance of treatment. Creating interventions that parallel the process of change offers the potential for personalizing and potentiating efforts to reduce the prevalence and consequences associated with compulsive or pathological and problem gambling. Application of this model to gambling behavior offers a heuristic that is intriguing and requires substantiation through rigorous research.     

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 Correlates of Gambling Among Minnesota Public School Students

This study examines the prevalence of gambling and measures the relationships between gambling behavior and a number of demographic, psychosocial, and behavioral variables among Minnesota public school students. The sample includes 78,582 male and female Minnesota public school students enrolled in the 9th and 12th grades. Students were administered the 1998 Minnesota Student Survey, a 121-item, anonymous, self-administered, paper-and-pencil questionnaire that inquires about multiple health-related content domains, including gambling behavior. The majority of students were found to have gambled at least once during the past year, however, most students did not report gambling frequently, nor did they report problems associated with their gambling. Boys reported gambling more often than girls, and older students gambled more often than younger students. A larger percentage of Mexican/Latin American, African American, American Indian, and mixed race students gambled at weekly and daily rates than Asian American and Caucasian students. Variables associated with gambling frequency included antisocial behavior, gender (being a male), alcohol and tobacco use, age, feeling bad about the amount of money they bet, a desire to stop gambling, and increased sexual activity. Gambling appears to be related to other risk-taking behaviors and may be a part of the adolescent experimentation with adult behaviors.     

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.     

Gender Differences in Characteristics of Chinese Treatment-Seeking Problem Gamblers

A total of 952 (841 men and 111 women) Chinese treatment-seeking problem gamblers completed self-report assessment forms. Female in contrast to male gamblers were more likely to be older, married, less educated, and without employment. Female gamblers also started gambling at an older age, had a shorter gambling history, preferred casino and mahjong gambling, and reported more somatic complaints and suicidal thoughts. Male and female gamblers accumulated similar amount of gambling debt and reported an average of 12 gambling-related problems on the Chinese version of the South Oaks Gambling Screen [Lesieur and Blume (Am J Psychiatry 144:1184–1188, 1987)]. Both groups were similarly troubled by their indebtedness, inability to control gambling, and gambling-related interpersonal problems. However, female gamblers had fewer means to pay their gambling debt. Given that significant gender-related differences were observed in Chinese problem gamblers, prevention and treatment services should attend to specific needs of male and female gamblers.     

The South Oaks Gambling Screen-revised Adolescent (SOGS-RA) Revisited: A Cut-point Analysis

The lack of a criterion validity gold standard defining adolescent pathological gambling represents a major limitation of the adolescent gambling literature. The present study employed Receiver Operating Characteristic curve analysis (ROC) to examine the performance of the South Oaks Gambling Screen-Revised Adolescent (SOGS-RA) recommended cut-point of 4 against two-proxy gold standards: self-identified need for, or receipt of, help for gambling. Logistic regression analysis examined the correlates of self-identified need for help with gambling. The sample was comprised of 12990 adolescents from Atlantic Canada whose average age was 15 years and 50% of whom were male. The SOGS-RA performed as well or better with these proxy gold standards than with proxies used in previous studies. We concluded that the proxy gold standards based on self-identified need for or receipt of help represent a pragmatic solution to the lack of an adolescent-specific definition of problem or pathological gambling. Students in grade seven and SOGS-RA scores of 4 or greater were independent predictors of self-identifying a need for help.     

Disordered Gambling among College Students: A Meta-Analytic Synthesis

The purpose of this study was to use a meta-analytic procedure to synthesize the rates of disordered gambling for college students that have been reported in the research literature. In order to identify all possible studies that met stringent inclusion criteria, Medline, PsychINFO, and SocioIndex databases were searched with the terms “gambling,” and “college student”. This process resulted in 15 studies concerning gambling among college students that were published through July 2005. To synthesize the 15 studies, a random effects model for meta-analysis was applied. The estimated proportion of disordered gamblers among college students was 7.89%. This estimate is noteworthy because it is higher than that reported for adolescents, college students or adults in a previous study using meta-analytic procedures with studies conducted prior to 1997.     

Adverse Childhood Experiences and Gambling: Results From a National Survey

Pathological gambling disorder and problem gambling are addictive disorders with severe consequences for individuals, families, and society. Knowledge about associations between childhood adverse experiences (i.e., physical, sexual, and emotional abuse) and gambling pathology in adulthood is limited. Using data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), associations between adverse childhood experiences and lifetime gambling status were tested. Strong bivariate associations between adverse childhood experiences and gambling status were found, which were attenuated with the inclusion of clinical covariates. Adverse childhood experiences might be related to pathological gambling in adulthood, but this relationship might not be gambling-specific.     

Casino Gambling Among Older Adults in North Dakota: A Policy Analysis

This article examined social issues surrounding casino gambling among older adults both nationally and in the state of North Dakota. An exploratory review of gambling trends among older adults and an examination of policies to protect older gamblers revealed that older adults are targeted by the gaming industry as a lucrative market (Singh et al. J Retail Leisure Property 2007, 6(1):61–68). The authors used the national literature to frame their qualitative study, which explored gambling issues among older adults in North Dakota from the perspective of six counselors trained in gambling addiction who provide treatment services in the state. Findings indicated that relatively few policies existed at the state and national levels to protect older, more vulnerable adults who gamble. Further, the six casinos in North Dakota were viewed as very effective in marketing their casino gaming opportunities to older citizens by the gambling treatment providers interviewed. Additionally, barriers to gambling addiction treatment involved lack of available services and distance to receive services in this rural state. Based on the findings of this study, social policy changes which could lead to increased protection for older adult gamblers in the state were included.     

Offspring of Parents with Gambling Problems: Adjustment Problems and Explanatory Mechanisms

We compared offspring of problem gamblers (n = 42) to offspring of parents without gambling problems (n = 100) to see (1) whether the two groups differed with respect to depressive feelings and conduct/antisociality problems and (2) whether ineffective parenting or the offspring’s own gambling problems played a mediating role in this context. Participants were drawn from a relatively large community-based study (N = 1,872). Parents rated their own gambling and other mental health problems when their children were in mid-adolescence. The children’s self-reports on depressive feelings and conduct/antisociality problems were assessed at two points in time: by mid-adolescence and again by early adulthood. Results showed that children of parents with gambling problems reported more depressive feelings and more conduct problems by mid-adolescence than children of parents without gambling problems. Children of problem gamblers also experienced an increase in their depressive symptoms from mid-adolescence to early adulthood. Importantly, ineffective parenting, but not children’s gambling problems, mediated almost all the links between parental problem gambling and children’s adjustment problems. These results add to a very small data base showing that children of problem gamblers are at risk for a variety of adjustment problems.