Estimating the prevalence of adolescent gambling disorders: A quantitative synthesis and guide toward standard gambling nomenclature

Predictors of pathological gambling behaviours in parents population in Nigeria

The increasing incidence of psychological pains, burnout, and anxiety among gamblers in Nigeria is high. This is because pathological gambling (PG) is on the rise and it is linked to many social vices such as stealing, drug abuse, and sexual abuse. It is important to investigate the trajectories of PG in Nigeria. A cross-sectional survey design was employed in our study with 197 participants sampled from 28 gambling venues in Nigeria made up the study's sample size. Of the 197, 131 (66.5%) were males and 66 (33.5%) were females. 50 (25.4%) were within the age range of 20-30 years, 42 (21.3%) were within 31-40 years, 40 (20.3%) were within 41-50 years, 35 (17.8%) were within 51-60 years, and 30 (15.2%) were within 61 and above. Using the hierarchical regression analysis, our finding revealed a significant association between psychological distress and our respondents' pathological gambling behaviour whereas none of the sociodemographic variables made a significant contribution to their pathological gambling behaviour. We concluded that gamblers' psychological well-being is crucial to understanding their problematic gambling behaviours in the context of a developing nation such as Nigeria, and that this could be similar among our respondents. Implications of our findings were highlighted.

Young male athletes at risk for problem gambling: Findings from a cross-sectional study in Sweden

Previous research has shown that male athletes at the elite level in Sweden have a higher proportion of gambling problems than the average male population in the country. However, there is a knowledge gap in the prevalence of gambling problems among young athletes. To address this gap, this study aimed to explore gambling behavior among young athletes and to examine the associations between individual and environmental factors and problem gambling. The cross-sectional survey comprised questions from the Problem Gambling Severity Index and the Alcohol Use Disorders Identification Test, in addition to self-constructed items on individual and environmental factors. The data were derived from a sample of 1,636 students from the National Sports Education Program (NIU) and 816 grassroots athletes of the same age (16-20 years old). The results showed that male athletes had a higher prevalence of problem gambling compared to female athletes, and that a large proportion of male athletes had gambled during school hours. The prevalence of problem gambling was almost zero for women. The prevalence of problem gambling among male athletes over 18 years of age was 9% in NIU athletes and 3.6% in grassroots athletes, while for men under 18 years of age, the prevalence was 4.9% in NIU athletes and 1.3% in grassroots athletes. The study highlights the importance of considering contextual factors such as the school and team environment in preventing problem gambling among young male athletes.

Gambling and internet addiction: a pilot study among a Population of Italian Healthcare : Gambling and Internet Addition in a Healthcare Group

AIM

Measuring the phenomenon of gambling and Internet addiction, with analysis of attitudes and psychophysical consequences among nurses working in different care settings.

METHODS

An observational, cross sectional, multicenter study was conducted from April to September 2020. Participants' socio-demographic information, the "Internet Addiction Test" (IAT) scale, and the "South Oaks Gambling Screen" (SOGS) were collected in order to assess the overuse of and whether an individual has a problematic relationship with gambling, respectively.

RESULTS

502 nurses were enrolled in the study. Significant correlations were found (p < .001) between the IAT score and gender, number of years of work experience, job role, educational qualification; and between the SOGS and gender, number of years of work experience, job role and regions of Italy.

CONCLUSIONS

The study highlighted an emerging social problem, and the results may be just the tip of the iceberg. Given the lack of knowledge of these phenomena and a high percentage of people who suffer from them but are afraid to admit it and get help, this study could also be useful in expanding knowledge and allow more professionals to get help and learn about possible treatments and cures for the resolution of these addictions.

Contentious Issues and Future Directions in Adolescent Gambling Research

Background. There is currently considerable public policy and regulatory interest in the nature and prevalence of underage gambling. Research in this area has purported to show that adolescents are at elevated risk of problem gambling and that early exposure to gambling or gambling-like activities could be a potential precursor to future harm. Method. In this commentary, we provide a critical appraisal of these arguments with reference to major studies in the field of gambling studies. It is argued that adolescent gambling research is a contentious area. Some questions remain concerning the validity of adolescent problem gambling measures, the strength of the association between adolescent and adult gambling and the impact of simulated gambling activities. Results. The paper summarises the conceptual and methodological issues that should be considered and addressed in future studies to strengthen the validity of research in this area. Conclusion. The paper encourages the greater use of harm-based measures, longitudinal and individual-level transition analyses and questions that capture the influence of activities rather than just their temporal sequencing.

An Exploratory Analysis of Predictors of Course in Older and Younger Adults with Pathological Gambling: A Non-Treatment Sample

We examined the association of baseline social, demographic, and clinical predictor variables with course in 48 older (≥ 60 years) and 57 younger (< 40 years) subjects with pathological gambling (PG) in a prospective follow-up study. Weekly gambling activity was tracked and used to categorize PG course. Generalized estimating equation models were used to examine predictors of disordered (i.e., level 2 or 3) gambling. Interaction tests were used to test for differential relationships for older and younger subjects. Predictors of disordered gambling during follow-up included greater severity of PG symptoms, greater severity of depressive symptoms, self-reported childhood neglect, cognitive distortions related to games of chance, and more role limitations due to physical health. Interaction tests showed that the relationships between some risk factors and disordered gambling varied for older and younger adults. Understanding these interrelationships could allow clinicians to more effectively monitor and manage their patients with PG.

Are Comorbid Disorders Associated with Changes in Gambling Activity? A Longitudinal Study of Younger and Older Subjects with DSM-IV Pathological Gambling

This study investigates the association of comorbid disorders with gambling activity in a longitudinal follow-up study of younger and older adult subjects with DSM-IV pathological gambling (PG). The subjects included 57 younger adults with PG (≥ 18/ < 40 years) and 48 older adults with PG (≥ 60 years). Subjects were assessed at baseline and every 6 months for a mean (SD) of 31.4 (13.1) months. Comorbidity was assessed using a modification of the Longitudinal Interval Follow-up Evaluation (LIFE). During follow-up, rates of problem severity were highest for anxiety disorders, mood disorders, and impulse control disorders. Among all subjects with PG, greater severity of depression or posttraumatic stress disorder was associated with increased gambling activity. In older subjects, greater severity of agoraphobia and social phobia were associated with lowered gambling activity. In younger subjects, greater severity of any substance use disorder, an alcohol use disorder, or compulsive computer use were associated with lowered gambling activity. The latter findings provide presumptive evidence for the substitute addiction hypothesis. We conclude that increased severity of several comorbid disorders could serve as triggers for increased gambling or predict lowered gambling activity. On the other hand, certain comorbid disorders could be triggered by increased gambling activity. Knowing these interrelationships is important to gaining a better understanding of PG and its clinical management.

Gambling and Problem Gambling among Minnesota Public School Students in 2019

This study has three specific aims. First, examine gambling participation and problem gambling rates for 2019. Second, compare 2019 rates of gambling participation and problem gambling to 2016 to determine if rates increased, decreased or stayed the same. Third, examine what demographic, psychosocial and behavioral variables are associated with adolescent problem gambling. The 2019 sample includes 55,552 male and 58,155 female Minnesota public school students enrolled in the 8^th, 9^th, and 11th grades and the 2016 sample includes 58,232 male and 59,294 female students from 8^th, 9^th, and 11^th grades. Students were administered the Minnesota Student Survey. For 2019, the gambling participation rate was 29.6%, the frequent gambling rate was 6.5%. The problem gambling rate was 0.5% with an additional 2.3% that had problems associated with their gambling but it did not reach the threshold of problem gambling. More boys gambled than girls (38.5% versus 21.1%); more boys gambled frequently than girls (9.7% versus 3.4%); and more boys were positive for problem gambling than girls (0.9% versus 0.2%). There were fewer students gambling in 2019 (29.6%) than in 2016 (32.1%). There were fewer students gambling frequently in 2019 (6.5%) than in 2016 (7.5%). There was no change in the problem gambling rate (0.5%) between 2016 and 2019. Tobacco use and antisocial behaviors were related to problem gambling but only accounted for 16% of the variance in problem gambling. There is a small segment of the adolescent population that gambles excessively and experiences problems associated with their gambling.

The personality profile of chronic alcohol dependent patients with comorbid gambling disorder symptoms

BACKGROUND AND AIMS

The importance of personality characteristics in the diagnosis and treatment of gambling disorder (GD) and alcohol use disorder (AUD) is often highlighted in scientific literature. This study aimed to test predictions about the associations of temperament and character in chronic AUD patients with comorbid GD symptoms and without them.

METHODS

Chronic AUD patients enrolled from an inpatient clinic were divided in two groups based on cluster analysis, AUD patients with (AUD + GD group: n = 30) and without (AUD group: n = 68) GD symptoms. Severity of GD symptoms and personality dimensions (Cloninger's Temperament and Character Inventory Revised, TCI-R) were assessed. Associations of tested variables were analysed with analysis of covariance, one-sample and independent sample t-tests.

RESULTS

GD symptoms proved to be a clustering factor in terms of personality, where AUD + GD group expressed a more maladaptive personality profile. Compared to Hungarian normative TCI-R scores, both patient groups showed elevated levels of Harm Avoidance and Novelty Seeking with lower scores of Self-directedness, while the AUD + GD group scored lower on Persistence and Cooperation as well. The AUD + GD group reported significantly higher levels of Harm Avoidance, with lower scores of Reward Dependence compared to the AUD group.

DISCUSSION

Comorbid GD symptom severity is an important factor in chronic AUD, where AUD patients with comorbid GD symptoms exhibited a more maladaptive personality constellation than singular AUD patients. These emphasize the need of special attention for comorbid GD symptoms in AUD, since treatment recommendations and prognosis for them may also differ.

Religiosity and Chance Beliefs in Persons with DSM-IV Pathological Gambling Enrolled in a Longitudinal Follow-Up Study

This study investigates the association of public, private and intrinsic religiosity and chance beliefs (superstition, illusion of control) with gambling behavior in a longitudinal follow-up study of younger and older adult subjects with DSM-IV pathological gambling (PG) and an older adult comparison group without PG. One-hundred sixty-three subjects were enrolled including 60 younger adults with PG (≥ 18/< 40 years), 53 older adults with PG (≥ 60 years), and 50 older adults without PG (≥ 60). Subjects were assessed at baseline and every 6 months thereafter. The Duke University Religion Index for Religious Assessment and the Drake Beliefs About Chance scales were administered at baseline. Follow-up was a mean (SD) of 2.6 (1.4) years. Older adults with PG scored lower on measures of public and intrinsic aspects of religiosity than older adults without PG, and scored higher on superstition and illusion of control. Older adults with PG also scored higher than younger adults with PG on private and intrinsic religiosity, but not public religiosity. Superstition predicted intrinsic, but not other aspects of religiosity. Importantly, during follow-up, higher levels of public and intrinsic religiosity were protective against problematic (levels 2, 3) gambling; were protective against chronic PG; and were predictive of PG remission status. Lower illusion of control ratings were protective against problematic gambling and chronic PG; lower superstition ratings were predictive of remission. We conclude that higher levels of public and intrinsic religiosity and lower levels of chance beliefs are associated with a more benign PG course.

Youth Gambling in Hong Kong: Prevalence, Psychosocial Correlates, and Prevention

PURPOSE

Youth gambling has long been considered a risk behavior and public health concern. Compared to Western literature, empirical studies on youth gambling in Hong Kong are scarce. The present review paper aims to provide an overall picture about the prevalence rates and psychosocial correlates of Hong Kong young people's gambling behaviors, as well as existing prevention/intervention measures.

METHODS

We searched literature in four major databases (PubMed, Sociological Abstracts, PsycINFO, and Web of Science), government documents and commissioned research reports. A total of 28 published papers on youth gambling in Hong Kong were identified and reviewed.

RESULTS

The results showed that a high percentage of Hong Kong youth involved in gambling activities and the prevalence rate of problem/pathological gambling was comparable to the global findings. Risk factors at individual, family and peer, and environmental levels were identified which provide useful information for the development of prevention strategies targeting youth gambling. While intervention and prevention services are available in Hong Kong, programmes specifically designed for young people are limited.

CONCLUSIONS

The findings suggest that there is a need to conduct longitudinal studies based a more representative sample of adolescents in Hong Kong with consistent measures and cut-off criterion.

Assessing the Psychometric Properties of the Internet Addiction Test (IAT) Among Lebanese College Students

Internet addiction is an emergent problem; yet, both a strong conception of the factors precipitating challenging activities and a gold standard tool for evaluating symptoms are deficient. The aim of this study was to carry out a psychometric analysis using the most commonly employed screening tool, the young Internet Addiction Test (IAT), comprising a sample of Lebanese University medical students. Two hundred and fifty-six undergraduate medical students from a university in Beirut, Lebanon were included in our IAT. Exploratory factor analysis was employed, and four factors were extracted. These four factors were named as Lack of Control, Social Withdrawal and Emotional Conflict, Time Management Problems, and Concealing Problematic Behavior. Furthermore, the selected factors explained 56.5% of the total variance. Cronbach's alpha coefficient for the internal reliability of the scale was found to be 0.91. For each subscale, the internal consistency score was approximated and detected as 0.76, 0.74, 0.69, and 0.63 for the first through fourth factor, respectively. Item total correlations were calculated and had a value range from 0.37 to 0.63 for the 20 items. IAT is a proper tool for evaluating internet addiction in Lebanese college students.

Who Really Wins? Efficacy of a Croatian Youth Gambling Prevention Program

This paper reports on the development and pilot evaluation of a Croatian school-based youth gambling prevention program "Who really wins?". The program is aimed at minimizing risk and enhancing protective factors related to youth gambling. A short-term evaluation of the program was conducted with a sample of 190 first and second year high-school students (67.6% boys, aged 14-17 years; average age 15.61). An experimental design with two groups (Training vs. No Training) and two measurement sessions (pre-test and post-test sessions) was used to evaluate change in problem gambling awareness, cognitive distortions, knowledge of the nature of random events as well as in social skills. Results showed significant changes in the post-test sessions, which can be attributed to changes in the Training group. We observed a decrease in risk factors, namely better knowledge about gambling and less gambling related cognitive distortions. Immediate effects on protective factors such as problem solving skills, refusal skills, and general self-efficacy were not observed. Findings also show program effects to be the same for both boys and girls, students from different types of schools, for those with different learning aptitudes, as well as for those at different risk levels with regard to their gambling, which speaks in favour of the program's universality. The program had no iatrogenic effects on behaviour change and shows promise as an effective tool for youth gambling prevention. Future research and a long-term evaluation are needed to determine whether the observed changes are also linked to behavioural change.

Relationships Between Perceived Family Gambling and Peer Gambling and Adolescent Problem Gambling and Binge-Drinking

The study systematically examined the relative relationships between perceived family and peer gambling and adolescent at-risk/problem gambling and binge-drinking. It also determined the likelihood of at-risk/problem gambling and binge-drinking as a function of the number of different social groups with perceived gambling. A multi-site high-school survey assessed gambling, alcohol use, presence of perceived excessive peer gambling (peer excess-PE), and family gambling prompting concern (family concern-FC) in 2750 high-school students. Adolescents were separately stratified into: (1) low-risk, at-risk, and problem/pathological gambling groups; and, (2) non-binge-drinking, low-frequency-binge-drinking, and high-frequency-binge-drinking groups. Multinomial logistic regression showed that relative to each other, FC and PE were associated with greater likelihoods of at-risk and problem/pathological gambling. However, only FC was associated with binge-drinking. Logistic regression revealed that adolescents who endorsed either FC or PE alone, compared to no endorsement, were more likely to have at-risk and problem/pathological gambling, relative to low-risk gambling. Adolescents who endorsed both FC and PE, compared to PE alone, were more likely to have problem/pathological gambling relative to low-risk and at-risk gambling. Relative to non-binge-drinking adolescents, those who endorsed both FC and PE were more likely to have low- and high-frequency-binge-drinking compared to FC alone or PE alone, respectively. Family and peer gambling individually contribute to adolescent at-risk/problem gambling and binge-drinking. Strategies that target adolescents as well as their closely affiliated family and peer members may be an important step towards prevention of harm-associated levels of gambling and alcohol use in youths.

Comparative Test Evaluation: Methods and Challenges

The present paper has three objectives. First, methods for comparing alternative tests for the purpose of replacement of one test with a second presumably superior test are described. Second, problems in the interpretation of the relevance of different diagnostic thresholds (thresholds of positivity) that define who is and who is not a disordered gambler are examined and a potential solution offered in the form of a common quantitative measure of the risk of being a disordered gambler. Third, alternative methodologies are described as potential solutions to the lack of a gold or reference standard in the evaluation of new tests.

Cross Validation of the Gambling Problem Severity Subscale of the Canadian Adolescent Gambling Index (CAGI/GPSS) on a Sample of Ontario High School Students

This paper reports on the cross validation of the Gambling Problem Severity Subscale of the Canadian Adolescent Gambling Index (CAGI/GPSS). The CAGI/GPSS was included in a large school based drug use and health survey conducted in 2015. Data from students in grades 9–12 (ages 13–20 years) derived from the (N = 3369 students). The CAGI/GPSS produced an alpha of 0.789. A principle component analysis revealed two eigenvalues greater than one. An oblique rotation revealed these components to represent consequences and over involvement. The CAGI/GPSS indicated that 1% of the students fell into the “red” category indicating a severe problem and an additional 3.3% scored in the “yellow” category indicating low to moderate problems. The CAGI/GPSS was shown to be significantly correlated with gambling frequency (r = 0.36), largest expenditure (r = 0.37), sex (more likely to be male) (r = −0.19), lower school marks (r = −0.07), hazardous drinking, (r = 0.16), problem video game play (r = 0.16), as well as substance abuse. The CAGI/GPSS was cross validated using a shorted version of the short SOGS, r = 0.48. In addition the CAGI/GPSS and short SOGS produced very similar patterns of correlations results. The results support the validity and reliability of the CAGI/GPSS as a measure of gambling problems among adolescents.

A prospective follow-up study of younger and older subjects with pathological gambling

Pathological gambling (PG) is a common and costly public health problem associated with impaired quality of life and high suicide rates. Despite its frequency in the general population, PG course is poorly understood in older adults who are especially vulnerable to its devastating consequences. We enrolled 175 subjects in a longitudinal study of gambling behavior: our case group of 53 older adults with PG (≥ 60 years), and two comparison groups including 72 younger adults with PG (< 40 years) and 50 older adults without PG (≥ 60 years). Subjects with PG met lifetime criteria for DSM-IV PG and had a South Oaks Gambling Screen (SOGS) and National Opinion Research Center DSM Screen for Gambling Problems (NODS) scores ≥ 5. Subjects were evaluated at intake and reassessed every 6 months and drop outs were replaced. Follow-up lasted a mean (SD) of 2.6 (1.4) years. At intake older PGs were more likely to be female, Caucasian, divorced, and to have a lower level of education. Older and younger PGs were similar in gambling severity, but older PGs were more likely to have sought PG treatment. Older PGs had lower rates of lifetime drug use disorders, attention deficit/hyperactivity disorder, and obsessive-compulsive disorder. They preferred slots, were more likely to receive PG treatment, and were less likely to discontinue participation in the study. Week by week gambling activity levels showed a significant general downward movement for older and younger PGs, although there were no differences between the groups. Elders without PG had no change in their level of gambling activity. We conclude that younger and older PGs moved toward a reduced level of gambling activity during follow-up. Our data challenge the notion that PG is chronic and progressive.

SOGS-RA gambling scores and substance use in adolescents

Background and aims There is a well-established association between pathological gambling and substance use disorders in adolescents. The aim of this study was to shed light on the association between adolescents' different levels of involvement in gambling activities and substance use (smoking tobacco and cannabis and drinking alcoholic beverages), based on a large sample. Methods A survey was conducted in 2013 on 34,746 students attending 619 secondary schools, who formed a representative sample of the Italian 15- to 19-year-old population. The prevalence of different categories of gamblers was estimated by age group and gender. A multiple correspondence analysis (CA) was conducted to explain the multivariate associations between substance use and gambling. Results The prevalence of problem gambling was 2.7% among the 15- to 17-year-olds, and rose to 3.6% among the 18- and 19-year-olds. Multiple CA revealed that, even when it does not reach risk-related or problem levels, gambling is associated with the use of alcohol and tobacco. In particular, the analysis showed that non-problem gambling levels were associated with alcohol and tobacco use at least once in the previous month, and that higher-risk gambling levels related to the use of cannabis and episodes of drunkenness at least once in the previous month. Conclusion This study found that any gambling behavior, even below risk-related or problem levels, was associated with some degree of substance use by youths, and that adolescents' levels of gambling lay along a continuum of the categories of substance use.

Sex-specific enhancement of palatability-driven feeding in adolescent rats

It has been hypothesized that brain development during adolescence perturbs reward processing in a way that may ultimately contribute to the risky decision making associated with this stage of life, particularly in young males. To investigate potential reward dysfunction during adolescence, Experiment 1 examined palatable fluid intake in rats as a function of age and sex. During a series of twice-weekly test sessions, non-food-deprived rats were given the opportunity to voluntarily consume a highly palatable sweetened condensed milk (SCM) solution. We found that adolescent male, but not female, rats exhibited a pronounced, transient increase in SCM intake (normalized by body weight) that was centered around puberty. Additionally, adult females consumed more SCM than adult males and adolescent females. Using a well-established analytical framework to parse the influences of reward palatability and satiety on the temporal structure of feeding behavior, we found that palatability-driven intake at the outset of the meal was significantly elevated in adolescent males, relative to the other groups. Furthermore, although we found that there were some group differences in the onset of satiety, they were unlikely to contribute to differences in intake. Experiment 2 confirmed that adolescent male rats exhibit elevated palatable fluid consumption, relative to adult males, even when a non-caloric saccharin solution was used as the taste stimulus, demonstrating that these results were unlikely to be related to age-related differences in metabolic need. These findings suggest that elevated palatable food intake during adolescence is sex specific and driven by a fundamental change in reward processing. As adolescent risk taking has been hypothesized as a potential result of hypersensitivity to and overvaluation of appetitive stimuli, individual differences in reward palatability may factor into individual differences in adolescent risky decision making.

Faith's wager: How religion deters gambling

The relationship between religion and gambling has only rarely been investigated in sociology and related fields. Prior studies have found that religion, broadly defined, deters gambling, with different religious traditions exhibiting varying degrees of deterrence. Our study, a quantitative analysis of a recent representative sample of U.S. adults, theorizes and tests how three different dimensions of religion affect three distinct forms of gambling. Religious tradition and religious service attendance are found to reduce the likelihood of casino gambling and lottery play; while religious salience is the only dimension that constrains online gambling. We argue that these findings reflect variation in the social visibility, time intensity, and broader legitimacy associated with gambling forms, and that this variation is crucial for understanding the deterring effects of faith.

“It’s Only a Game of Chance”: A Portrait of Gambling Among Street Children in Mumbai

For street children in Mumbai, gambling is mostly a social and recreational activity. This study is based on data gathered from a survey of 70 youths aged 12 to 24, two focus groups, and participant observation. It offers glimpses into various facets of their gambling, including age patterns, games played, venues, and how group and street subculture strongly influence participation. Street children perceive gambling as a “game of chance,” implying it is a form of recreation, not to be taken seriously. Given the pervasiveness of gambling and the absence of other recreational and money-saving opportunities, there is a need to design educational and preventive interventions for street children.

Assessment of High School Students’ Understanding of DSM-IV-MR-J Items

The current study examines the understanding of the DSM-IV-MR-J items to assess pathological gambling among adolescents aged 12 to 15, and explores its accuracy. The DSM-IV-MR-J was first administered in the classroom. Participants were assigned to either an experimental or a control group. Participants in the first group were asked to explain the meaning of each DSM-IV-MR-J item during an individual interview. If the item was not properly understood, the investigator corrected the participant’s understanding of the item. The questionnaire was then administered a second time. The control group was only submitted to a test-retest procedure. The results showed that 22% of the items were misunderstood. Changes in diagnostic categories emerged on the second administration for both groups. A 20% and 29.4% decrease in the number of problem/pathological gamblers was observed in the experimental and control group. The implications of these results are discussed in terms of the reliability of the DSM-IV-MR-J as a measure of problem gambling among adolescents.

Problem Gambling Among Ontario Students: Associations with Substance Abuse, Mental Health Problems, Suicide Attempts, and Delinquent Behaviours

This paper describes gambling problems among Ontario students in 2009 and examines the relationship between gambling problems and substance use problems, mental health problem indicators, and delinquent behaviors. Data were derived from the Ontario Student Drug Use and Health Survey of Ontario students in grades 7-12. Gambling problems were measured as 2 or more of 6 indicators of problem gambling. In total 2.8% of the students surveyed endorsed two or more of the problem gambling items. The odds of problem gamblers reporting mental distress was 4.2 times higher than the rest of the sample and the odds of problem gamblers reporting a suicide attempt were 17.8 times greater than the rest of the sample. In addition compared to the rest of the students, delinquent behaviors were also more common among problem gamblers, including theft (OR = 14.5), selling marijuana (OR = 19.6), gang fights (OR = 11.3) and carrying a handgun (OR = 11.2). In a multivariate analysis, substance-use problems, mental health problems, and the participation in a variety of delinquent behaviors remained significantly associated with youth problem gambling behavior. Students who report problem gambling behaviors show increased substance abuse, mental health, and delinquency/criminal problems that are similar to those seen among adult problem gamblers. The association between these problems suggests that these problems could be addressed in a unified manner.

Understanding the Mechanisms Underlying Gambling Behaviour and Sleep

Problem gambling and sleep difficulty threaten health. Using the basis of self-regulatory theory, potential mechanisms for these problems were investigated. Fifty-nine treatment-seeking gamblers completed the Pittsburgh Sleep Quality Index (sleep difficulty), the Sleep Hygiene Index (negative sleep habits), the Problem Gambling Severity Index and measures of self-regulatory capacity and arousability with data entered into regression analyses. Results supported the relationship between problem gambling and greater sleep difficulty (β = .18, t = 3.22, p < .01). Self-regulatory capacity mediated the relationship between problem gambling and sleep difficulty (R (2) change = .15, F(2, 57) = 12.14, β = -.45, t = -3.45, p < .001) as well as between problem gambling and negative sleep habits; R (2) change = .17, F(2, 57) = 13.57, β = -.28, t = -3.76, p < .001. Arousability predicted sleep difficulty (β = .15, t = 3.07, p < .01) and negative sleep habits (β = .40, t = 5.40, p < .01) but showed no relationship with problem gambling (r = .09, ns). Self-regulatory capacity represents an important mediator of the relationship between problem gambling and sleep-related behaviour and if targeted could reduce behavioural threats to health.

Investigating Veterans' Pre-, Peri-, and Post-Deployment Experiences as Potential Risk Factors for Problem Gambling

Background and aims Gambling disorder and its comorbid diagnoses are observed at higher rates in military veterans than in the general population. A significant research gap exists regarding the relationships of veterans' life and service experiences to problematic gambling. The present study explored pre-, peri-, and post-deployment factors associated with problem gambling in veterans. Methods Veterans of Operation Iraqi Freedom, Operation Enduring Freedom, and Operation New Dawn (n = 738; 463 males, and 275 females) completed questionnaires via structured telephone interview. We conducted bivariate and multinomial logistic regression analyses exploring associations among problem-gambling severity and socio-demographic variables, psychiatric comorbidities, and 10 scales of the Deployment Risk and Resilience Inventory measuring experiences pre-, peri-, and post-deployment. Results Approximately 4.2% of veterans indicated at-risk or probable pathological gambling (ARPG) post-deployment (two or more DSM-IV criteria for pathological gambling). Bivariate analyses found more severe gambling in males, higher frequencies of post-traumatic stress disorder, substance dependence, traumatic brain injury, panic disorder, and depression in veterans with ARPG, and higher general harassment during deployment, and lower social support and more stressful life events post-deployment in those with ARPG. In multivariable models, both post-deployment factors remained significantly associated with ARPG. Discussion The study suggests that problem gambling among veterans is related to service experiences, and particularly to life experiences post-deployment. Conclusions Adverse service and life experiences and lack of social support may contribute to the risk of problem gambling in military veterans. Investigation of how Veterans Affairs clinical settings may serve veterans following deployment to prevent behavioral addictions is warranted.

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This study describes the initial gambling experiences of teenagers who have developed problem gambling habits with regard to: a) the nature of the gambling activities, b) the significance of the first experience in terms of the benefits and attractive aspects of gambling, and c) the progression toward the development of problematic behaviours. The research design draws on secondary analysis of data from semi-structured interviews carried out with 31 adolescents with problem gambling behaviours in treatment for the consumption of psychoactive substances (PS). An analysis of the teenagers' responses reveals the existence of material, emotive and social benefits associated with their first gambling experience and the exacerbation of their behaviours. The results were analysed in light of the teenagers' social context: popularity of certain games, importance of performance, wealth and the pursuit of pleasure.

Prevalence and Correlates of Problem Gambling in a Representative Sample of Norwegian 17-Year-Olds

We report data collected in a representative sample of 17-year-old Norwegians to investigate prevalence rates of non-problem, risk, and problem gambling, as measured by the Problem Gambling Severity Index (PGSI). In addition, we explored the importance of demographic, personality, motivational, social, and health variables explaining variance in adolescent gambling. Prevalence rates of risk and problem gambling were low but similar to those found in previous studies outside of Norway using the PGSI in adolescent samples. With regard to the relative importance of the various covariates, we found that motivational variables (future gambling intentions, attitudes toward gambling, and gambling-related knowledge) distinguished best between those who did not gamble, non-problem gamblers, and risk and problem gamblers. Furthermore, social variables were important covariates of adolescent gambling; significant associations were found for family and friends' approval of gambling, parental monitoring, father's level of education, and having relatives or friends with a history of a gambling disorder. We discuss possible reasons for differences between the covariates with regard to their importance for explaining adolescent gambling and address implications for future research.

Experience with Gambling in Late Childhood and Early Adolescence: Implications for Substance Experimentation Behavior

OBJECTIVE

Previous research among late adolescents suggests an additive association between levels of engagement in gambling and vulnerability to substance use disorder. The aim of our research was to investigate the frequency of gambling experience in childhood and early adolescence and to examine the association between alcohol/cigarette/energy drink consumption and gambling in this young population.

METHODS

A survey called "Pinocchio" was conducted during the 2013 to 2014 school year at primary and secondary schools in Padua (north-eastern Italy) on a sample of 1325 students in sixth to eighth grade (11-13 year olds). Multilevel analysis, taking the school-level variance into account, established an adjusted association between gambling and attitude to risk-taking among early adolescents.

RESULTS

Among eighth graders, 45.8% of the boys and 35.4% of the girls reported at least 1 type of gambling. In a fully-adjusted model, having experience of gambling confers a higher likelihood of being consumers (at least once a month) of other substances (alcohol, cigarettes, energy drinks, or marijuana).

CONCLUSION

Gambling behavior is widespread among adolescents. An association with other risk-taking behavior was found in this study, and this provides further evidence of the need for a greater awareness of gambling behavior in early adolescence.

The winner takes it all? Characteristics of adolescent at-risk/problem gamblers in Switzerland

BACKGROUND

Gambling has and still entertains people in almost all societies throughout the world. Western societies have faced considerable changes in the amount and accessibility of gambling possibilities during the last decades, and the rates of both adolescent gamblers and problem gamblers have increased significantly.

OBJECTIVE

To determine the characteristics of at-risk and problem adolescent gamblers in Switzerland.

SUBJECTS

The study population consisted of 3134 students (1669 females) attending post-mandatory education in 15 randomly chosen centres. Participants were divided into non- (n=2207), non-problematic (n=754) and at-risk/ problematic gamblers (n=176).

METHODS

Both gambling groups were compared to non-gamblers on socio-demographic measures, substance use and Internet use. Overall, 29.6% had gambled during the past year and 5.6% had gambled in a risky or problematic way. Compared to non-gamblers and after controlling for potential confounders, non-problem gamblers were significantly more likely to be male, apprentices and to misuse alcohol. At-risk/problematic gamblers were additionally more likely to smoke cannabis, to be problematic Internet users and to be non-Swiss than non-gamblers.

CONCLUSION

At-risk and problematic adolescent gambling is associated with other health risk behaviours. Health practitioners should include gambling in the psycho-social screening and preventive counselling of adolescents.

A descriptive analysis of demographic and behavioral data from Internet gamblers and those who self-exclude from online gambling platforms

As the popularity of internet gambling increases, the increased opportunities to participate serve to heighten concerns about the potential for gambling related harm. This paper focuses on self-exclusion as one of the main responsible gaming interventions, and is split into three sections. Firstly, we set out a three-tier model for assessing at-risk gambling behaviors which examines player exhibited, declared and inferred behavior. Secondly, we present a literature review relating to who self-excludes and whether self-exclusion is effective. Finally, we report the results of an analysis of the exhibited behavior of internet self-excluders as sampled from a research cohort of over 240,000 internet gaming accounts. Our analysis of self-excluders (N = 347) versus a control group (N = 871) of gamblers indicates self-excluders are younger than the control group, more likely to suffer losses and more likely to adopt riskier gambling positions. Unlike some previous studies, there was little difference in terms of mean gambling hours per month or minutes per session. Some self-excluders (N = 306) can be tracked from the date their account was created through their self-exclusion history, indicating a large number of very quick self-exclusions (e.g., 25 % within a day) and a small set of serial self-excluders. Younger and older males are likely to self-exclude faster than middle-aged males (N = 242), but there is no such age pattern across female self-excluders (N = 63).

Gambling behaviors and attitudes in adolescent high-school students: Relationships with problem-gambling severity and smoking status

BACKGROUND AND AIMS

Smoking is associated with more severe/extensive gambling in adults. The purpose of this study was to examine relationships between smoking and gambling in adolescents.

METHODS

Analyses utilized survey data from 1591 Connecticut high-school students. Adolescents were classified by gambling (Low-Risk Gambling [LRG], At Risk/Problem Gambling [ARPG]) and smoking (current smoker, non-smoker). The main effects of smoking and the smoking-by-gambling interactions were examined for gambling behaviors (e.g., type, location), and gambling attitudes. Data were analyzed using chi-square and logistic regression; the latter controlled for gender, race/ethnicity, grade, and family structure.

RESULTS

For APRG adolescents, smoking was associated with greater online, school, and casino gambling; gambling due to anxiety and pressure; greater time spent gambling; early gambling onset; perceived parental approval of gambling; and decreased importance of measures to prevent teen gambling. For LRG adolescents, smoking was associated with non-strategic gambling (e.g., lottery gambling); school gambling; gambling in response to anxiety; gambling for financial reasons; greater time spent gambling; and decreased importance of measures to prevent teen gambling. Stronger relationships were found between smoking and casino gambling, gambling due to pressure, earlier onset of gambling, and parental perceptions of gambling for ARPG versus LRG adolescents.

DISCUSSION

Smoking is associated with more extensive gambling for both low- and high-risk adolescent gamblers.

CONCLUSION

Smoking may be a marker of more severe gambling behaviors in adolescents and important to consider in gambling prevention and intervention efforts with youth.

Cigarette smoking, problem-gambling severity, and health behaviors in high-school students

Introduction

Smoking and gambling are two significant public health concerns. Little is known about the association of smoking and gambling in adolescents. The current study of high-school adolescents examined: (1) smoking behavior by problem-gambling severity and (2) health-related variables by problem-gambling severity and smoking status.

Methods

Analyses utilized survey data from 1591 Connecticut high-school students. Adolescents were classified by problem-gambling severity (Low-Risk Gambling [LRG], At-Risk/Problem Gambling [ARPG]) and smoking status (current smoker, non-smoker). Analyses examined the smoking behavior of ARPG versus LRG adolescents as well as the smoking-by-problem-gambling-severity interactions for health and well-being measures (e.g., grades, substance use). Chi-square and logistic regression analyses were used; the latter controlled for gender, race/ethnicity, school grade, and family structure.

Results

More adolescents with ARPG than LRG reported regular smoking, heavy smoking, early smoking onset, no smoking quit attempts, and parental approval of smoking. ARPG and LRG adolescents who smoked were more likely to report poor grades, lifetime use of marijuana and other drugs, current heavy alcohol use, current caffeine use, depression, and aggressive behaviors and less likely to report participation in extracurricular activities. The association between not participating in extracurricular activities and smoking was statistically stronger in the LRG compared to the ARPG groups. Post-hoc analyses implicated a range of extracurricular activities including team sports, school clubs, and church activities.

Conclusions

Smoking was associated with poorer health-related behaviors in both ARPG and LRG groups. Interventions with adolescents may benefit from targeting both smoking and gambling.

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We examined adolescent health behaviors by smoking status and gambling severity.

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Smoking was associated with poorer health behaviors for adolescent gamblers.

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Considering smoking may be helpful in interventions with adolescent gamblers.

From adolescent to adult gambling: an analysis of longitudinal gambling patterns in South Australia

Although there are many cross-sectional studies of adolescent gambling, very few longitudinal investigations have been undertaken. As a result, little is known about the individual stability of gambling behaviour and the extent to which behaviour measured during adolescence is related to adult behaviour. In this paper, we report the results of a 4-wave longitudinal investigation of gambling behaviour in a probability sample of 256 young people (50 % male, 50 % female) who were interviewed in 2005 at the age of 16-18 years and then followed through to the age of 20-21 years. The results indicated that young people showed little stability in their gambling. Relatively few reported gambling on the same individual activities consistently over time. Gambling participation rates increased rapidly as young people made the transition from adolescence to adulthood and then were generally more stable. Gambling at 15-16 years was generally not associated with gambling at age 20-21 years. These results highlight the importance of individual-level analyses when examining gambling patterns over time.

Validation of a subjective outcome evaluation tool for participants in a positive youth development program in Hong Kong

STUDY OBJECTIVES

Using confirmatory factor analyses, this study examined the factor structure and reliability of a subjective outcome evaluation tool for students with greater psychosocial needs within the context of the Project P.A.T.H.S. in Hong Kong.

DESIGN

To assess the views of program participants on the program content, implementer qualities, and program effectiveness of the Tier 2 Program of the Project P.A.T.H.S., the Subjective Outcome Evaluation Form for Participants (Form C) was used. Data were collected from 8,893 Grade 7 participants after they had completed the Tier 2 Program.

RESULTS

The findings based on confirmatory factor analyses are generally consistent with the original hypotheses, providing support for the 3-factor model and the higher-order factor model containing 3 primary factors. Support for different types of factorial invariance based on 2 randomly split subsamples was also found. High coefficient alphas were found for the total scale and the 3 subscales.

CONCLUSION

Confirmatory factor analyses support the conceptual model underlying the Form C. Reliability analyses showed that the total scale and subscales possess excellent internal consistency.

The Problematic and Risky Internet Use Screening Scale (PRIUSS) for Adolescents and Young Adults: Scale Development and Refinement

Problematic Internet use (PIU) is a growing health concern among adolescents and young adults. The purpose of this mixed-methods study was to develop and refine a theoretically-grounded and psychometrically-validated assessment instrument for PIU specifically tailored to adolescents and young adults. An item pool was developed using concept mapping and a review of the literature, and administered to 714 students from two universities between 18 and 25 years of age. Exploratory and confirmatory factor analyses were used in a development subsample (n=500) to construct the scale. A cross-validation sample (n=214) was used to confirm the scale's reliability. The Problematic and Risky Internet Use Screening Scale (PRIUSS) is an 18-item scale with three subscales: Social Impairment, Emotional Impairment, and Risky/Impulsive Internet Use. Based on its strong theoretical foundation and promising psychometric performance, the PRIUSS may be a valuable tool for screening and prevention efforts in this population.

Updates of the prevalence of problem gambling in Romanian teenagers

The aim of this study was to find out what is the prevalence of pathological in Romanian teenagers. We questioned one thousand thirty-two teenagers in Cluj-Napoca and Harghita counties. Participants completed a questionnaire with 40 items including gamblers anonymous twenty questions. The sample included teenagers aged 11-19 years; 65.57% were male and 34.43% were female. The subjects were divided into three groups: non-gambling/recreational gambling or occasional gambling (0-1 positive answers -Level 1)-753 subjects (72.96%) [316 females and 437 males]; problem gambling (2-6 points-Level 2)-243 subjects (23.54%) [43 females and 200 males]; pathological gambling (above 7 points-Level 3)-36 subjects (3.48%) [3 females and 33 males]. The mean age of pathological gamblers was 16.48 years. Gender differences were as expected, males engaging in pathological gambling (91.66% from pathological gamblers) more than females did (8.33% from pathological gamblers). Data revealed that the most encountered games practiced weekly were sport bets and slot machines in the case of 36.11% of the pathological gamblers; lotto, internet casino and pool bets each with 25%, followed by roulette and black-jack with 22.22%.From those who reported practicing gambling at a pathological level 66.66% engaged in alcohol consumption, 13.88% illicit drug use and 19.44% licit drugs. Just 16.66% smoke cigarettes. Data revealed higher rates of prevalence in Romanian teenagers than in other Central and Eastern European countries. A prevalence study at a national level should be designed.

Gambling problems in young people: experience from the Asian region

PURPOSE OF REVIEW

To introduce the existing research conducted into gambling problems among young people in the Asian region.

RECENT FINDINGS

The prevalence rates of gambling-related problems of young people ranged from 32 to 60% for participation, from 1.5 to 5.0% for problem gambling and from 0.07 to 2.66% for pathological gambling in Asia; social gambling and lottery were the most popular gambling types. Psychiatric comorbidity is common among pathological gamblers, but the causal mechanisms are unclear. The psychological theories on youth gambling in Asia included diathesis, motivation, stress, coping, cognitive and positive youth development. The Positive Adolescent Training through Holistic Social Programmers has been developed; this aims to intervene and help those young people experiencing gambling problems in Hong Kong.

SUMMARY

Published gambling studies on young people in Asia are limited and have different definitions, research tools and diagnostic criteria. Therefore, the results vary and are incomparable. More work needs to be done in the near future, on comorbidity mechanisms, the neuropsychological and neurobiological mechanisms of youth gambling and, importantly, an increase in early intervention programmes.

National gambling experiences in the United States: will history repeat itself?

AIMS

The aim of this paper is to offer an account of the history and current status of gambling research in the United States.

METHODS

A review of the literature.

RESULTS

Gambling has been a part of society in the United States since its early history. However, it was not until 1980 that the medical profession in the United States first recognized pathological gambling as a psychiatric disorder. Today, it is still rarely diagnosed or treated, and relatively little federal funding is available to support research in this area. With the upcoming fifth revision of the Diagnostic and Statistical Manual of Mental Disorders, pathological gambling is likely to be included alongside substance use disorders as the first non-substance-related addictive disorder. This change may represent an opportunity to expand research on gambling and treatment of pathological gambling.

CONCLUSIONS

We provide 10 suggestions for reducing societal and personal harm associated with this disorder.

Gambling-related attitudes and behaviors in adolescents having received instant (scratch) lottery tickets as gifts

OBJECTIVE

Instant (scratch) lottery ticket gambling is popular among adolescents. Prior research has not determined whether adolescents' gambling behavior and attitudes toward gambling are influenced by the receipt of scratch lottery tickets as gifts.

METHOD

Cross-sectional survey data from 2,002 Connecticut high school students with past-year gambling were analyzed using bivariate approaches and logistic regression analyses. Interactions between gambling-problem severity and lottery-gift status were examined in relation to multiple outcomes.

RESULTS

Adolescents who received a scratch lottery ticket as a gift compared with those who did not were more likely to report features of problem gambling, buy scratch lottery tickets for themselves, and buy and receive other types of lottery tickets; they were also less likely to report parental disapproval of gambling and to see gambling prevention efforts as important. Later (≥15 years) age-at-gambling-onset was inversely linked to gambling-problem severity in the lottery gift group (odds ratio [OR] = .38) but not in the nongift group (OR = .91), yielding a significant severity by gift status interaction. Other academic, health, and gambling-related correlates of gambling-problem severity were similar in the gift and nongift groups.

CONCLUSIONS

For adolescents, the receipt of scratch lottery tickets as gifts during childhood or adolescence was associated with risky/problematic gambling and with gambling-related attitudes, behaviors, and views suggesting greater gambling acceptability. The extent to which the receipt of scratch lottery tickets may promote gambling behaviors and the development of gambling problems warrants consideration. Education, prevention, and treatment strategies should incorporate findings relating to receipt of gambling products by underage individuals.

Youth aggressive/disruptive behavior trajectories and subsequent gambling among urban male youth

This study examines the association between aggressive/disruptive behavior development in two distinct developmental periods-childhood (i.e., Grades 1-3) and early adolescence (i.e., Grades 6-10)-and subsequent gambling behavior in late adolescence up to age 20. The sample consists of 310 urban males of predominately minority and low socioeconomic status followed from first grade to late adolescence. Separate general growth mixture models were estimated to explore the heterogeneity in aggressive/disruptive behavior development in the aforementioned two periods. Three distinct behavior trajectories were identified for each period: a chronic high, a moderate increasing, and a low increasing class for childhood, and a chronic high, a moderate increasing, followed by decreasing and a low stable class for early adolescence. There was no association between childhood behavior trajectories and gambling involvement. Males with a moderate behavior trajectory in adolescence where two times more likely to gamble compared to those in the low stable class (OR = 1.89, 95% CI = 1.11, 3.24). Those with chronic high trajectories during either childhood or early adolescence (OR = 2.60, 95% CI = 1.06, 6.38; OR = 3.19, 95% CI = 1.18, 8.64, respectively) were more likely to be at-risk/problem gamblers than those in the low class. Aggressive/disruptive behavior development in childhood and early adolescence is associated with gambling and gambling problems in late adolescence among urban male youth. Preventing childhood and youth aggressive/disruptive behavior may be effective to prevent youth problem gambling.

Gambling in Britain: the application of restraint erosion theory

AIM

To provide an overview of gambling and problem gambling in Britain, including historical background, current regulations and the recognition, prevalence and treatment of problem gambling.

METHODS

A new theory, Gambling Restraint Erosion Theory (GRET), is used as a framework for understanding the history of gambling regulation in Britain in the 20th century and evidence about the prevalence of gambling and problem gambling, as well as public attitudes towards gambling, in Britain in the first decade of the 21st century.

FINDINGS

Restraints on gambling were progressively dismantled as regulation moved from partial prohibition, to tolerance, and then to liberalization by the turn of the millennium. British adult gambling prevalence surveys carried out in 1999/2000, 2006/07 and 2009/10 suggest that the British public is still relatively restrained in its engagement in gambling, and is still suspicious of gambling. There is evidence from the last of those surveys that engagement in some forms of gambling, and the prevalence of problem gambling, have risen, and that attitudes have become less negative towards gambling.

CONCLUSIONS

Restraints which kept British gambling circumscribed, and the prevalence of problem gambling low, may be in the process of being eroded. Meanwhile, an effective public health response to problem gambling is constrained by lack of Department of Health interest and a failure to develop a research and treatment base independent of the gambling industry.