Measuring Gambling Problems Among Adolescents: Current Status and Future Directions

Problematic online gambling among adolescents: A systematic review about prevalence and related measurement issues

BACKGROUND AND AIMS

Despite its illegality among adolescents, online gambling is a common practice, which puts their mental health and well-being at serious risk. This systematic review summarises international scientific literature from the last 20 years on problematic online gambling among adolescents (11-21 years old) to determine its prevalence and to analyse related measurement issues.

METHODS

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed and a protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO, IC: CRD42020162932). Five academic databases were consulted, which resulted in an initial sample of 658 papers.

RESULTS

Sixteen studies met the inclusion criteria for this review. All studies were cross-sectional and targeted students from elementary school, secondary school or university. Most followed a convenience sampling procedure. The primary measurement instruments used were the DSM-IV-MR-J and SOGS-RA. Between 0.77% and 57.5% of adolescents present some degree of problematic online gambling (problem, pathological or disordered) depending on the instruments used, the study samples and the timeframe analysed. Between 0.89% and 1% of adolescents exhibited an online gambling disorder.

DISCUSSION AND CONCLUSION

There is a great heterogeneity in the methodology of the reviewed studies (samples, measurement instruments, cut-off points and criteria applied). The limited number of studies and the limited generalizability of their results suggest the need for further research and for development of specific instruments to assess different levels of problematic online gambling in representative samples of adolescents based on clinical 'gold standard' criteria and more accurate cut-off points.

Problem Gambling among Adolescent Girls in Croatia-The Role of Different Psychosocial Predictors

Although, compared to boys, adolescent girls gamble less often and less problematically, prevalence studies still show significant numbers of at risk/problem gamblers among girls. However, girl gambling has been on the sidelines of adolescent gambling research. The available studies usually focus only on a narrow set of correlates often ignoring that adolescent gambling is a complex phenomenon determined by various factors. Also, they often measure gambling related consequences with instruments that are not specifically developed for use on adolescents. In order to contribute to a better understanding of adolescent gambling this study focuses on problem gambling among girls. We consider different social, cognitive, motivational and behavioral factors as predictors of girl problem gambling. A total of 1,372 high-school girls from 7 Croatian cities participated in the study. They provided data on their gambling activities, peer gambling, cognitive distortions related to gambling, motivation for gambling, and levels of general risky behavior. As the only instrument developed specifically for use on adolescents, the Canadian Adolescent Gambling Inventory was used to examine adverse gambling consequences. Results show 7.4% of girls can be considered regular gamblers, and out of those who gambled at least once in their lifetime (n = 862), 11.2% already experience mild adverse consequences because of their gambling (at risk gamblers), with 3.2% experiencing serious consequences (problem gamblers). In general, girls seem to prefer lotto and scratch cards, but sports betting seems to be the preferred game of choice among regular girl gamblers. A hierarchical regression model confirmed the importance of much the same factors identified as risky for the development of problem gambling among adolescent boys—cognitive distortions, motives to earn money, to be better at gambling and to relax, the experiences of winning large and the drive to continue gambling, together with social factors such as having friends who also gamble, being involved in other risky and delinquent behavior and higher gambling frequency. Results call into question the importance of the motive to feel better for adolescent girls problem gambling. We discuss implications of our findings for both universal and indicated youth gambling prevention programs.

Reliability of Instruments Measuring At-Risk and Problem Gambling Among Young Individuals: A Systematic Review Covering Years 2009-2015

This review aims to clarify which instruments measuring at-risk and problem gambling (ARPG) among youth are reliable and valid in light of reported estimates of internal consistency, classification accuracy, and psychometric properties. A systematic search was conducted in PubMed, Medline, and PsycInfo covering the years 2009-2015. In total, 50 original research articles fulfilled the inclusion criteria: target age under 29 years, using an instrument designed for youth, and reporting a reliability estimate. Articles were evaluated with the revised Quality Assessment of Diagnostic Accuracy Studies tool. Reliability estimates were reported for five ARPG instruments. Most studies (66%) evaluated the South Oaks Gambling Screen Revised for Adolescents. The Gambling Addictive Behavior Scale for Adolescents was the only novel instrument. In general, the evaluation of instrument reliability was superficial. Despite its rare use, the Canadian Adolescent Gambling Inventory (CAGI) had a strong theoretical and methodological base. The Gambling Addictive Behavior Scale for Adolescents and the CAGI were the only instruments originally developed for youth. All studies, except the CAGI study, were population based. ARPG instruments for youth have not been rigorously evaluated yet. Further research is needed especially concerning instruments designed for clinical use.

Italian Adolescent Gambling Behaviour: Psychometric Evaluation of the South Oaks Gambling Screen: Revised for Adolescents (SOGS-RA) among a sample of Italian students

Since no Italian validated instrument focuses specifically on the measurement of pathological gambling in very young people, with this study, we aim to adapt an international instrument (SOGS-RA) and assess its psychometric properties in a sample (n = 14.910) of young Italian students aged between 15 and 19 years. Cross-cultural adaptation of the instrument was performed through translation, synthesis of translation, back-translation, expert committee review, and pre-testing. The kappa statistic for test-retest concordance ranged from 0.53 to 0.80. Internal validity was assessed by the MCA that identified one principal component with eigenvalue equal to 3,875: the Divgi index and very simple structure analysis also pointed out one common factor, so uni-dimensionality of the SOGS-RA was accepted. Moreover the SOGS-RA was found to have acceptable internal consistency (α = 0.780). Cronbach's alpha was also assessed separately among males and females (respectively 0.786 and 0.707). The SOGS-RA was assessed in relation to gambling frequency, alcohol and drug use: Chi squared test revealed a strong association both for males and females with gambling frequency (p value ≤ 0.0001), frequent use of illicit drugs (for each drug p value ≤ 0.0001) and having had 3 or more occasions of binge drinking in the last month (p value ≤ 0.0001). At the end we can say that, the results of our study suggest that the SOGS-RA screen may be useful to assess at-risk or problem gambling for both genders in comprehensive youth surveys.

Adolescent gambling: a review of an emerging field of research

PURPOSE

The purpose of this review was to summarize the research on adolescent gambling with implications for research and prevention or intervention.

METHOD

The methodology involved a comprehensive and systematic search of "adolescent or youth gambling" in three diverse electronic databases (MedlineAdvanced, PsycINFO, and Sociological Abstracts) and three peer-reviewed journals (International Journal of Gambling Studies, International Journal of Mental Health and Addiction, and Journal of Gambling Issues).

RESULTS

The search resulted in 137 articles (1985-2010) focusing on gambling among youth aged between 9 and 21 years: 103 quantitative, 8 qualitative, and 26 non-empirical. The study of adolescent gambling can be summarized as follows: (a) it is conducted by a relatively small group of researchers in Britain, Canada, and the United States; (b) it is primarily prevalence-focused, quantitative, descriptive, school-based, and atheoretical; (c) it has most often been published in the Journal of Gambling Studies; (d) it is most often examined in relation to alcohol use; (e) it has relatively few valid and reliable screening instruments that are developmentally appropriate for adolescents, and (f) it lacks racially diverse samples.

CONCLUSION

Four recommendations are presented for both research and prevention or intervention which are as follows: (1) to provide greater attention to the development and validation of survey instruments or diagnostic criteria to assess adolescent problem gambling; (2) to begin to develop and test more gambling prevention or intervention strategies; (3) to not only examine the co-morbidity of gambling and alcohol abuse, but also include other behaviors such as sexual activity; and (4) to pay greater attention to racial and ethnic differences in the study of adolescent gambling.

Conceptualizing and treating problem gambling as a family issue

Few family therapists have training in the identification, assessment, and treatment of problem gambling and its impact on couple and family relationships. The authors conceptualize problem gambling (PG) as a family issue and encourage clinicians and researchers to pay attention to the systemic antecedents and consequences of PG on family relationships. A review of the literature and clinicians' experiences regarding the impact of PG on couple and family relationships are presented and discussed. In light of the limited systemic-based treatments for PG, marriage and family therapists are urged to begin paying attention to this emerging issue that has significant couple and family ramifications.

A national study on gambling among US college student-athletes

OBJECTIVE

The authors examined the national prevalence of gambling problems and sports wagering among US college student-athletes.

PARTICIPANTS

A national sample of 20,739 student-athletes participated in the study.

METHODS

The authors used data from the first national survey of gambling among college athletes, conducted by the National Collegiate Athletic Association.

RESULTS

Men (62.4%) consistently had higher past-year prevalence of gambling than did women (42.8%). The authors identified 4.3% of men and 0.4% of women as problem or pathological gamblers. Among the most popular forms of gambling were playing cards, lotteries, and games of skill, with male-to-female prevalence ratio ranging 1.3-5.6 across various gambling activities. Athletes in golf and lacrosse were more likely to report sports wagering than were other athletes. Athletes in gender-specific sports wagered more prevalently than did athletes in unisex sports.

CONCLUSION

Gambling prevalence may be underestimated in this population because respondents' athletics eligibility is at stake. This study provides important baseline data for future cohorts of athletes.

Gambling and health risk behaviors among U.S. college student-athletes: findings from a national study

PURPOSE

To examine prevalence and associations of gambling problems and health risk behaviors among college athletes from the first national survey of gambling among U.S. college student-athletes.

METHODS

Conducted by the National Collegiate Athletic Association (NCAA), this self-administered and anonymous survey collected information from a nationally representative sample of 20,739 student-athletes.

RESULTS

Males consistently had higher past-year prevalence of gambling than females (e.g., 62.4% of males reported some type of gambling vs. 42.8% of females). Based on DSM-IV Gambling Screen, this study identified 4.3% of males and 0.4% of females as problem/pathological gamblers. A general upward trend existed that as the level of gambling problems increased, so did the prevalence of substance use, gorging/vomiting, and unprotected sex. Cross-group comparisons by gambler type were all significant. Problem and pathological gamblers also experienced significantly more drug/alcohol-related problems than non-gamblers and social gamblers.

CONCLUSIONS

Direct associations found between gambling and multiple risk behaviors in college student-athletes support the persistence of the youth problem-behavior syndrome and suggest the need for multi-faceted initiatives to tackle these risk behaviors simultaneously.