Comparisons between the South Oaks Gambling Screen and a DSM-IV-based interview in a community survey of problem gambling

Problem Gambling Poker Players: Do They Fit into Blaszczynski and Nower's Pathways Model?

Blaszczynski and Nower's (Addiction 97:487-499, 2002) Pathways Model, an integrative model based on problem gamblers' paths and comorbidities, aids in understanding the heterogeneity of problem gamblers' profiles by classifying them into three subgroups. The profiles of problem gamblers may be linked to the type of gambling practiced. Poker is a popular game, primarily due to the involvement of both chance and strategy in its outcome. However, no study has attempted to fit poker players into the Pathways Model. We recruited an online sample of 245 regular poker players (including 146 non-problem gamblers, 83 problem-gambling poker players, and 16 probable pathological gamblers). We assessed multiple variables (impulsivity, sensation seeking, alcohol and tobacco consumption, anxiety, depression, cognitive distortions) from the Pathways Model to determine whether the profiles of poker players fit into one or more gambler subgroups. Cluster analysis showed that poker players had a unique profile with a gambling practice intensity gradient. Compared to non-problem gamblers, problem gamblers displayed significantly higher levels of depression, impulsivity, gambling-related cognitive distortions, and alcohol consumption. Our results suggest that problem-gambling poker players fit into Blaszczynski and Nower's behaviorally conditioned gamblers group. This study opens avenues for both research into and treatment for problem gambling among poker players.

The Association between the Five-factor Model of Personality and Problem Gambling: a Meta-analysis

This meta-analysis examined the associations between five-factor personality model traits and problem gambling. To be eligible for inclusion in the meta-analysis, studies had to provide effect size data that quantified the magnitude of the association between all five personality traits and problem gambling. Studies also had to use psychometrically sound measures. The meta-analysis included 20 separate samples from 19 studies and 32,222 total participants. The results showed that problem gambling was significantly correlated with the five-factor model of personality. The strongest personality correlate of problem gambling was neuroticism r = .31, p = < 0.001, 95% CI [0.17, 0.44], followed by conscientiousness r = − .28, p = < 0.001, 95% CI [-0.38,-0.17] ), agreeableness r = − .22, p = < 0.001, 95% CI [-0.34, − 0.10], openness r = − .17, p = < 0.001, 95% CI [-0.22,-0.12], and extraversion r = − .11, p = .024, 95% CI [-0.20,-0.01]. These results suggest problem gamblers tend to share a common personality profile – one that could provide clues as to the most effective ways to prevent and to treat problem gambling.

Impulsive decision-making predicts the course of substance-related and addictive disorders

BACKGROUND

This study investigated whether patterns of impulsive decision-making (i) differ between individuals with DSM-5 substance use disorders (SUD) or non-substance-related addictive disorders (ND) and healthy controls, and (ii) predict the increase of SUD and ND severity after one year.

METHODS

In a prospective-longitudinal community study, 338 individuals (19-27 years, 59% female) were included in one of three groups: SUD (n = 100), ND (n = 118), or healthy controls (n = 120). Group differences in four impulsive decision-making facets were analyzed with the Bayesian priors: delay discounting (mean = 0.37, variance = 0.02), probability discounting for gains and for losses (each - 0.16, 0.02), and loss aversion (- 0.44, 0.02). SUD and ND severity were assessed at baseline and after 1 year (n = 312, 92%). Predictive associations between decision-making and SUD/ND severity changes were analyzed with the Bayesian prior: mean = 0.25, variance = 0.016.

RESULTS

Compared with controls, the SUD group displayed steeper delay discounting and lower probability discounting for losses; the ND group displayed lower probability discounting for losses (posterior probabilities > 98%). SUD symptom increase after 1 year was predicted by steeper delay discounting and lower loss aversion; ND symptom increase by lower probability discounting for losses and lower loss aversion (posterior probabilities > 98%). There was low evidence for predictive relations between decision-making and the quantity-frequency of addictive behaviours.

DISCUSSION

Impulsive decision-making characterizes SUD and ND and predicts the course of SUD and ND symptoms but not the engagement in addictive behaviours. Strength of evidence differed between different facets of impulsive decision-making and was mostly weaker than a priori expected.

Spatial and sociodemographic correlates of gambling participation and disorder among female Filipino migrant workers in Macao, People's Republic of China

BACKGROUND AND AIMS

Correlates and risk factors for gambling disorder among vulnerable or transient populations such as transnational migrant workers are unknown. The current study examined sociodemographic and spatial correlates of gambling disorder among female Filipino domestic workers in Macao (SAR), China.

DESIGN

Survey-based, respondent-driven sampling study administered from November 2016 to August 2017.

SETTING

Macao (SAR), which encompassed 38 casinos within its 30.4 km² area at the time of this study.

PARTICIPANTS

Representative sample of N = 1194 female Filipino domestic workers in Macao.

MEASUREMENTS

Symptoms of gambling disorder based on Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Correlates evaluated included sociodemographic information, proximity to venues, perceived social support, and symptoms of depression and anxiety.

FINDINGS

Prevalence of gambling disorder was 5.1%. Multivariable regression analyses indicated that likelihood of gambling participation (i.e., ever gambling) was associated with current indebtedness (RR = 1.56, 95%CI = 1.08-2.25, p = .017) and worse self-reported health (RR = 1.31, 95%CI = 1.04-1.65, p = .02). Increased symptoms of gambling disorder were independently associated with lower perceived social support (RR = 0.92, 95%CI = 0.87-0.98, p = .006), increased dependents relying upon monthly remittances (RR = 1.10, 95%CI = 1.06-1.16, p < .001), increased depression severity (RR = 1.16, 95%CI = 1.07-1.25, p < .001), decreased salary quintile (RR = 0.97, 95%CI = 0.94-1.00, p = .04), and proximity to the nearest Mocha Club gaming venues (RR = 1.04, 95%CI = 1.02-1.07, p = .005). The association between proximity to casinos and increased symptoms of gambling disorder was significant only for domestic workers living apart from employers (RR = 1.07, 95%CI = 1.00-1.14, p = .04).

CONCLUSIONS

Increased spatial proximity to gambling venues and greater financial and psychosocial burdens are associated with gambling disorder among domestic workers in Macao.

Telecommunications Network Measurements of Online Gambling Behavior in Switzerland: A Feasibility Study

BACKGROUND

Methodological shortcomings of gambling studies relying on self-report or on data sets derived from gambling operators tend to result in biased conclusions. The aim of this study was to analyze online gambling behavior using a novel network database approach.

METHODS

From October 13 to October 26, 2014, telecommunications network data from a major telecommunications provider in Switzerland were analyzed. Netflows between mobile devices and a poker operator were quantified to measure the gambling duration and session number.

RESULTS

Time spent gambling during night and working hours was compared between devices with longest (red group), intermediate (orange group), and shortest gambling time (green group). Online gambling behavior differed depending on overall gambling time, F (2, 3,143). Night and working hours gambling was the highest in the red group (53%), compared to the orange (50.1%) and the green groups (41.5%). Post hoc analyses indicated significant differences between the orange and green groups (p < 0.05). No differences were observed between the red and orange groups (p = 0.850), and the red and green groups (p = 0.053).

CONCLUSIONS

On mobile devices, distinct gambling patterns were observed depending on the overall gambling time. This methodology could also be used to investigate online gaming, social media use, and online pornography.

Endorsement of Criminal Behavior Amongst Offenders: Implications for DSM-5 Gambling Disorder

The fifth edition of the diagnostic and statistical manual (DSM) has changed the scoring threshold for a gambling disorder (GD) from five criteria to four and eliminated the illegal acts criterion. The impact of these changes was examined with data from a correctional population (N = 676) in Ontario, Canada. The offenders completed a self-report survey that included the Canadian problem gambling index, the South Oaks Gambling Screen and the DSM-IV criteria. Changing the threshold from 5 to 4 improved the convergent validity for GD and resulted in an increase in the percentage of offenders diagnosed with a GD from 7.4 to 10.2 %. The results also indicate that the illegal acts criterion contributes to the convergent validity of GD. The evidence supports the change in the threshold from five to four, but also reinforces the importance of examining illegal acts when dealing with an offender population. The incorporation of illegal acts into the “lying to others” criteria appears to make up, to some extent, for the removal of the illegal acts criterion.

Treatment of Pathological Gambling Using a Guided Self-Change Approach

Pathological gamblers are prone to leave treatment early and often display low levels of motivation within treatment. Use of brief treatments that emphasize reducing client ambivalence through motivational techniques may help increase the likelihood of treatment compliance. This case study describes a 5-session treatment of pathological gambling using a brief and motivationally focused cognitive—behavioral guided self-change (GSC) approach. The 36-year-old gambler in this study was treated for pathological gambling. At 1-month and 6-month follow-ups, the individual evidenced significant improvement in symptoms of pathological gambling. The client also showed considerable reductions in gambling behaviors including number of gambling episodes, length of time spent gambling, and amount of money wagered. These results support use of the GSC approach in treating pathological gamblers.

Differential Gambling Motivations and Recreational Activity Preferences Among Casino Gamblers

This study investigated three different types of gamblers (recreational, problem, and pathological gamblers) to determine differences in gambling motivations and recreational activity preferences among casino gamblers. We collected data from 600 gamblers recruited in an actual gambling environment inside a major casino in South Korea. Findings indicate that motivational factors of escape, sightseeing, and winning were significantly different among these three types of gamblers. When looking at motivations to visit the casino, pathological gamblers were more likely to be motivated by winning, whereas recreational gamblers were more likely to be motivated by scenery and culture in the surrounding casino area. Meanwhile, the problem gamblers fell between these two groups, indicating higher preferences for non-gambling activities than the pathological gamblers. As this study builds upon a foundational previous study by Lee et al. (Psychiatry Investig 6(3):141-149, 2009), the results of this new study were compared with those of the previous study to see if new developments within a resort-style casino contribute to changes in motivations and recreational activity preferences.

Dimensionality of Cognitions in Behavioral Addiction

Cognitive constructs provide conceptual frameworks for transpathological characterization and improved phenotyping of apparently disparate psychiatric groups. This dimensional approach can be applied to the examination of individuals with behavioral addictions, for example, towards gambling, video-games, the internet, food, and sex, allowing operationalization of core deficits. We use this approach to review constructs such as impulsivity, compulsivity, and attention regulation, which may be most relevant, applicable, and successful for the understanding and subsequent treatment of the addictions.

How much gambling is too much? Identifying potential problem gambling among adolescents

AIMS

Using a population-based sample of Finnish 12-17 year olds, this study explored gambling behaviour limits for potential problem gambling [South Oaks Gambling Screen - revised for adolescents (SOGS-RA)].

METHODS

Data were obtained from the Youth Gambling Survey 2006, which is a cross-sectional survey of a nationally representative random sample of 5000 adolescents. Adolescents who participated in gambling at least once a month were selected from the data (n=1827, 25.1% were girls). The limits for gambling behaviour were detected using receiver operating characteristic (ROC) analysis. Logistic regression was used to study associations between these behavioural limits and potential problem gambling.

RESULTS

For each of the gambling behaviour indicators plotted, the risk curves showed similar trends among boys and girls. The risk of being a potential problem gambler increased noticeably with increasing gambling intensity. The ROC analysis showed that the optimal behavioural cut-off values among 12-14 year olds for frequency was gambling more than 2-3 times a month, spending more than €2 per week on gambling, spending more than €8 in any 1 day on gambling, and gambling on more than two different games per year. For 15-17 year olds, cut-off values were gambling more than once a week, spending more than €4 per week and spending more than €12 in any 1 day on gambling. Cut-off for number of game types was same as it was for younger adolescents. Of the behavioural indicators those associated with money were the most robust.

CONCLUSION

Behavioural indicators can be used as initial markers of possible problem gambling.

Comorbid physical and mental illnesses among pathological gamblers: Results from a population based study in Singapore

The aim of the current study was to examine the comorbidity of pathological gambling with other mental and physical disorders as well as to examine health related quality of life perceived by those with pathological gambling using data from a community survey in Singapore. All respondents were administered the South Oaks Gambling Screen to screen for pathological gambling. The diagnosis of mental disorders was established using the Composite International Diagnostic Interview; while chronic physical conditions were established using a checklist. The weighted lifetime prevalence of pathological gambling was 2.7%. After multiple logistic regression, age 18-34 years (OR=5.3, 95% CI=1.6-17.4), male gender (OR=7.8, CI=3.8-16.2), widowhood (OR=4.2, 95% CI=1.02-17.5), and those with pre-primary (OR=17.1, CI=4.9-59.1), primary (OR=5.3, CI=1.7-16.6), and secondary education (OR=6, CI=2.5-14.7) had significantly higher odds of having pathological gambling. Those of Malay (OR=0.1, 95% CI=0.07-0.2) and Indian ethnicity (OR=0.2, 95% CI=0.1-0.3) had significantly lower odds of having pathological gambling compared to those of Chinese ethnicity. Pathological gamblers had significantly higher odds of having comorbid mental and physical disorders than non-gamblers/non-problem gamblers. The significant association of comorbid mental and physical disorders among those with pathological gambling indicates a need to screen for these disorders and for their subsequent treatment.

Associations between sensitivity to punishment, sensitivity to reward, and gambling

The majority of individuals gamble during their lifetime; however only a subset of these individuals develops problematic gambling. Gray's Reinforcement Sensitivity Theory may be relevant to understanding gambling problems. Differences in sensitivity to punishments and rewards can influence an individual's behavior and may be pertinent to the development of gambling problems. This study examined the functional associations between sensitivity to punishment (SP), sensitivity to reward (SR), and gambling problems in a sample of 2254 college students. Zero-inflated negative binomial regression was used to predict gambling problems as well as the absence of gambling problems. Gambling problems were hypothesized to be positively associated with SR and inversely associated with SP. In addition, SP was hypothesized to moderate the association between SR and gambling problems, attenuating the strength of the association. As hypothesized, SR was positively associated with gambling problems. However, SP did not moderate the relationship between SR and gambling problems. SP did, however, moderate the relationship between SR and the likelihood of never experiencing gambling problems. The results demonstrate that individual differences in SP and SR are functionally associated with gambling problems.

Correlates of depressive symptom severity in problem and pathological gamblers in couple relationships

Problem and pathological gamblers (PPG) often suffer from depressive symptoms. Gambling problems have negative consequences on multiple aspects of gamblers' lives, including family and marital relationships. The objectives of the current study were to (1) replicate the results of studies that have suggested a stronger and more significant relationship between gambling and depression in PPG than in non-problem gamblers (NPG) and (2) explore specific correlates of depressive symptom severity in PPG in couple relationships. Variables demonstrated to be significantly correlated with depressive symptoms in the general population were selected. It was hypothesized that gender, age, gambler's mean annual income, perceived poverty, employment status, clinical status (i.e., problem or pathological gambler versus non-problem gambler), trait anxiety, alcoholism, problem-solving skills, and dyadic adjustment would be significant predictors of depressive symptoms. Sixty-seven PPG were recruited, primarily from an addiction treatment center; 40 NPG were recruited, primarily through the media. Results revealed that PPG reported significantly greater depressive symptoms than did NPG. Further, elevated trait anxiety and poor dyadic adjustment were demonstrated to be significant and specific correlates of depressive symptom severity in PPG. These findings contribute to the literature on depressive symptomatology in PPG in relationships, and highlight the importance of the influence of the couple relationship on PPG.

Multidimensional examination of impulsivity in relation to disordered gambling

Impulsivity has been consistently associated with pathological gambling (PG), but the diversity of definitions and measures of impulsivity has led to ambiguity with regard to which indices are independently relevant. Toward clarifying this relationship, the current study examined indices from an array of commonly used impulsivity measures in relation to PG severity in an adult community sample of frequent gamblers (N = 353). These included both survey assessments and behavioral tasks. Using a factor analytic approach, 4 latent factors were identified among 19 indices and were designated reward sensitivity, punishment sensitivity, delay discounting, and cognitive impulsivity. All 4 latent variables were positively and independently related to PG severity, albeit at a trend level for cognitive impulsivity in a combined model. These findings reveal 4 generally independent domains of impulsivity that are related to PG severity, clarify which assessment measures aggregate in each domain, and illustrate the importance of measurement specificity in studying impulsivity in relation to PG and other psychiatric disorders.

Evaluating the South Oaks Gambling Screen with DSM-IV and DSM-5 criteria: results from a diverse community sample of gamblers

Despite widespread use, the South Oaks Gambling Screen (SOGS) has been criticized for excessive false positives as an indicator of pathological gambling (PG), and for items that misalign with PG criteria. We examine the relationship between SOGS scores and PG symptoms and convergent validity with regard to personality, mood, and addictive behaviors in a sample of 353 gamblers. SOGS scores correlated r = .66 with both DSM-IV and DSM-5 symptoms, and they manifested similar correlations with external criteria (intraclass correlation of .95). However, 195 false positives and 1 false negative were observed when using the recommended cut point, yielding an 81% false alarm rate. For uses with DSM-IV criteria, a cut point of 10 would retain high sensitivity with greater specificity and fewer false positives. For DSM-5 criteria, we advocate a cut point of 8 for use as a clinical screen and a cut point of 12 for prevalence and pseudo-experimental studies.

Psychological therapies for pathological and problem gambling

BACKGROUND

Various psychological therapies for pathological and problem gambling have been evaluated in randomised trials. A synthesis of best-quality evidence is required.

OBJECTIVES

The objective was to synthesise evidence from randomised trials of psychological therapies for pathological and problem gambling (cognitive-behaviour therapy (CBT), motivational interviewing therapy, integrative therapy, other psychological therapy), in order to indicate the efficacy of therapies and durability of therapy effects, relative to control conditions.

SEARCH METHODS

We conducted a search of the Cochrane Depression, Anxiety and Neurosis Review Group's Specialised Register (CCDANCTR), which includes relevant randomised controlled trials from the following bibliographic databases: CENTRAL (The Cochrane Central Register of Controlled Trials) (all years), EMBASE (1974 -), MEDLINE (1950 -) and PsycINFO (1967 -). We also carried out complementary searches of MEDLINE, EMBASE, PsycINFO, LILACS and CENTRAL for studies published between January 1980 and October 2011. We examined the WHO International Clinical Trials Registry Platform and ClinicalTrials.gov and also conducted manual searches of selected journals and reference lists of included studies.

SELECTION CRITERIA

Included studies were clinical trials using random allocation to groups, considering pathological or problem gamblers, and evaluating a psychological therapy for pathological or problem gambling. Control conditions included 'no treatment' controls, referral to Gamblers Anonymous and non-specific treatment component controls.

DATA COLLECTION AND ANALYSIS

We systematically extracted data on the characteristics and results of studies. Primary outcomes were measures of gambling symptom severity, financial loss from gambling and frequency of gambling. Secondary outcomes were occurrence of pathological gambling diagnoses and depression and anxiety symptoms. Treatment effects were defined by comparisons between therapy and control conditions at post-treatment assessments (conducted from 0 to 3 months following completion of treatment) and follow-up assessments (conducted from 9 to 12 months following completion of treatment), respectively, using the standardised mean difference (SMD) or risk ratio (RR). We synthesised results through random-effects meta-analysis.

MAIN RESULTS

Fourteen studies (n = 1245) met the inclusion criteria. Eleven studies compared CBT with control and comparisons at 0 to 3 months post-treatment showed beneficial effects of therapy that ranged from medium (when defined by financial loss from gambling: SMD -0.52; 95% confidence interval (CI) -0.71 to -0.33, n = 505) to very large (for gambling symptom severity: SMD -1.82; 95% CI -2.61 to -1.02, n = 402). Only one study (n = 147) compared groups at 9 to 12 months follow-up and produced smaller effects that were not significant. Four studies of motivational interviewing therapy were identified and mainly considered samples demonstrating less severe gambling (relative to studies of pathological gamblers). Data suggested reduced financial loss from gambling following motivational interviewing therapy at 0 to 3 months post-treatment (SMD -0.41; 95% CI -0.75 to -0.07, n = 244), although comparisons on other outcomes were not significant. The effect approached zero when defined by gambling symptom severity (SMD -0.03; 95% CI -0.55 to 0.50, n = 163). Studies compared groups at 9 to 12 months follow-up and found a significant effect of motivational interviewing therapy in terms of frequency of gambling (SMD -0.53; 95% CI -1.04 to -0.02, n = 62), with comparisons on other outcomes that were not significant. Two studies of integrative therapies also considered samples demonstrating overall low gambling severity, and found no significant effects of therapy at 0 to 3 months post-treatment. Comparisons at 9 to 12 months follow-up suggested a medium effect from therapy in terms of gambling symptom severity, with no significant differences for other outcomes. One study (n = 18) considered another psychological therapy (i.e.Twelve-Step Facilitated Group Therapy) and suggested beneficial effects in terms of most outcomes at 0 to 3 months post-treatment. The evidence supporting these various classes of therapy ranged from very low to low quality.

AUTHORS' CONCLUSIONS

This review supports the efficacy of CBT in reducing gambling behaviour and other symptoms of pathological and problem gambling immediately following therapy. However, the durability of therapeutic gain is unknown. There is preliminary evidence for some benefits from motivational interviewing therapy in terms of reduced gambling behaviour, although not necessarily other symptoms of pathological and problem gambling. However, the findings are based on few studies and additional research is needed to inform conclusions. There is also evidence suggestive of some possible benefit from integrative therapies, and other psychological therapies for pathological and problem gambling. However, there are too few studies and evidence is insufficient to evaluate these therapies. The majority of studies in this review varied in risk of bias, and much of the evidence comes from studies with multiple limitations. The current data may thus reflect overestimates of treatment efficacy.

Gambling behavior and problems among older adults: a systematic review of empirical studies

OBJECTIVES

With the rapid aging of the population and the increased availability of gambling facilities over the past three decades, older adults may gamble more and may be increasingly at risk for problem gambling (PG) or pathological gambling disorder (PGD). To facilitate a better understanding of gambling behavior among older adults that will inform preventive strategies, this article systematically examined empirical studies on issues related to older adults' gambling.

METHOD

This article reviewed 75 empirical studies including data on the distribution and determinants of PG and PGD and the outcomes of gambling.

RESULTS

This review used the broad term of "disordered gambling" as a means to explain a continuum of problems caused by PG and PGD. The analyses covered seven topics concerning older adults' gambling behaviors: Participation rates for gambling, prevalence rates of disordered gambling, motivation for initially beginning to gamble, risk and protective factors for disordered gambling, and negative and positive health outcomes from gambling.

DISCUSSION

Based on research gaps identified in the review, this article proposes six recommendations for future studies focusing on well-being of older adults who gamble, research method issues, and taking into account older adults' inspirations and adjustment to the aging process in the 21st century.

High-stakes gambling: seniors may be the losers

The U.S. government has almost always allowed some limited legal gambling. In recent years, gambling has proliferated and is legal in some form, including racetracks, casinos, lotteries, bingo, and cards, in almost every state. Observational data and anecdotal reports have created concern that gambling rates, and especially rates of problem gambling, are increasing, especially among the elderly. Most research on gambling among the elderly is conducted in casinos, simply because so many elders visit them, and they are now the largest gambling venues in the nation. Risk factors for problem gambling include alcohol or substance abuse, low socioeconomic neighborhood residence, access to gambling opportunities, family and friend acceptance of gambling, and participation in a greater number of gambling types. More than 80% of elders gamble as a social activity and gamble responsibly. However, some elders are problem or pathological gamblers, and are vulnerable to financial instability. Currently, people older than 65 years of age comprise 39% to 45% of casinos' traffic, partly because casinos target this market heavily. Once it becomes clear that gambling is a problem, individuals can receive counseling and interventions such as a 12-step program and cognitive-behavioral therapy. Pharmaceutical interventions are fairly new, but promising.

Gambling in Western and Eastern Europe: the example of Hungary

The history of gambling in post-socialist countries is noticeably different from that of other countries in Europe. The goal of this study was therefore twofold: Firstly, to systematically review all European epidemiological studies related to excessive gambling in the general adult population, and secondly, to provide an overview of the state of gambling in Hungary based on the first ever nationwide representative survey, setting the results against the backdrop of the earlier European studies. A systematic review was carried out of European gambling studies which focus on a representative adult general population. Hungarian data was obtained from the National Survey on Addiction Problems in Hungary general adult population survey (N = 2,710). Pathological gambling was measured by the South Oaks Gambling Screen. Lifetime prevalence of excessive gambling (problem and pathological gambling) in the general adult population of European countries varies between 1.1% (Italy and Spain) and 6.5% (Estonia). In Hungary, the prevalence of problem gambling is 1.9%, with pathological gambling at 1.4%. The socio-demographic characteristics of the results are similar to those of other European countries. Using epidemiological data from the general adult populations of two post-socialist nations, it was possible to compare the results with data from 12 other European countries. Based on the data available, the extremely rapid liberation of the gambling market in the post-socialist countries has led to a similarly swift escalation in associated gambling problems.

Internet gambling and risk-taking among students: An exploratory study

BACKGROUND AND AIMS

Internet gambling is undergoing a massive worldwide expansion. The relationship between the convenience, anonymity, and the 24-hour availability of Internet gambling and problem gambling in young people presents a serious concern. This study explored general gambling behavior, including Internet gambling (with and without money), problem gambling, and risk-approach motivation in a sample of university students aged 18 to 20 years.

METHODS

University undergraduates (N = 465) in two urban universities completed in-class paper-and-pencil questionnaires concerning Internet gambling, risk taking, and a checklist of the DSM-IV criteria for problem gambling.

RESULTS

Overall, 8.0% of participants reported past-year gambling for money on the Internet, with significantly higher rates among males (11.8%) than females (0.6%). Based on DSM-IV criteria, 3.7% of respondents were classified as problem gamblers (i.e., endorsed 3 or more items). There were higher rates of problem gambling among those who had gambled on the Internet, and students who had gambled on the Internet had higher risk-approach scores.

CONCLUSIONS

The results of this study suggest that students who have gambled on the Internet have greater risk-taking motivation than students who have not gambled online, and those classified as problem gamblers have greater risk-taking motivation than non-gamblers. Results also suggest both higher risk taking scores and classification as a high risk-taker predict online gambling. Gambling on the Internet may be harmful for some individuals; young males, those with high risk-approach motivation, and, most certainly, those already exhibiting problem gambling behaviors.

Intergenerational transmission of gambling: links between young adult and perceived grandparent gambling attitudes and behavior

This study examined associations between the gambling attitudes and behavior of 213 young adults and their perceptions of the gambling attitudes and behavior of their closest grandparent. Regression analyses showed that young adult gambling attitudes mediated the relations between perceived grandparent gambling attitudes and behavior and young adult gambling behavior. Grandparent-grandchild relationship quality experienced while growing up did not moderate the relations between young adult and perceived grandparent gambling attitudes and behavior. Men experienced gambling at a younger age and reported more positive gambling attitudes, more frequent gambling activity, higher levels of gambling pathology, and higher levels of gambling affinity than women. Implications of results and suggestions for future research are discussed.

Differences in pathological gambling prevalence estimates: facts or artefacts?

The paper aims at investigating whether survey methodology has recently converged to justify the common practice of comparing prevalence estimates and interpreting differences within and between countries. To this end, prevalence studies of problem (PrG) and pathological gambling (PG) published in peer-reviewed journals between 2000 and 2010 were critically reviewed. A systematic computer-based literature search was conducted within various databases and major gambling journals. In a two-step search process, a total of 39 studies reporting current prevalence data of non-clinical national samples from different countries were identified. Analyses revealed wide ranges in estimated PrG/PG rates for adults, adolescents, and college students, whereas similar estimates were reported in two studies on PrG/PG in seniors. Despite the discussion on methodological consistency in the field of gambling research, comparability of the reported estimates was found to be still highly limited by major variation between studies with regard to survey description, administration format, exclusion criteria, assessment instrument, cut-off scores, sample frame, and reference period. The interpretation of differences in PrG and PG prevalence estimates within and between countries may be improved by using valid and reliable instruments and by applying comparable survey methodology in well-defined populations.

Trait gambling cognitions predict near-miss experiences and persistence in laboratory slot machine gambling

'Near-miss' outcomes (i.e., unsuccessful outcomes close to the jackpot) have been shown to promote gambling persistence. Although there have been recent advances in understanding the neurobiological responses to gambling near-misses, the psychological mechanisms involved in these events remain unclear. The goal of this study was to explore whether trait-related gambling cognitions (e.g., beliefs that certain skills or rituals may help to win in games of chance) influence behavioural and subjective responses during laboratory gambling. Eighty-four individuals, who gambled at least monthly, performed a simplified slot machine task that delivered win, near-miss, and full-miss outcomes across 30 mandatory trials followed by a persistence phase in extinction. Participants completed the Gambling-Related Cognitions Scale (GRCS; Raylu & Oei, 2004), as well as measures of disordered gambling (South Oaks Gambling Screen [SOGS]; Lesieur & Blume, 1987) and social desirability bias (DS-36; Tournois, Mesnil, & Kop, 2000). Skill-oriented gambling cognitions (illusion of control, fostered by internal factors such as reappraisal of losses, or perceived outcome sequences), but not ritual-oriented gambling cognitions (illusion of control fostered by external factors such as luck or superstitions), predicted higher subjective ratings of desire to play after near-miss outcomes. In contrast, perceived lack of self-control predicted persistence on the slot machine task. These data indicate that the motivational impact of near-miss outcomes is related to specific gambling cognitions pertaining to skill acquisition, supporting the idea that gambling near-misses foster the illusion of control.

Gambling Among Adults in Germany: Prevalence, Disorder and Risk Factors

Aims: The present study aimed at analyzing prevalence of participation in gambling activities, gambling disorder as well as associated risk factors in the German adult population. Methods: Data came from the 2009 Epidemiological Survey of Substance Abuse (ESA) using a mixed-mode design including questionnaires, telephone and Internet interviews. The cross-sectional random sample consisted of 8,006 subjects aged 18 to 64 years. The response rate was 50.1 %. Results: With a 12-month prevalence of 48.0 %, gambling was a common activity differing by gender (males: 53.9 %, females: 42.0 %). Prevalence of pathological gambling (PG; past 12 months) was estimated at 0.3 % and at 1.1 % for subthreshold pathological gambling (SPG). Various socioeconomic characteristics were related to SPG and/or PG. Male gender and non-German nationality have shown the greatest risk factors for PG. Moreover, gambling frequency and multiple gambling participation were positive associated with SPG and PG. A strong association was found for preference for Internet gambling with SPG and for preference for gaming machines and sports events with PG. Conclusions: The results indicate that SPG was genuinely different from gambling without endorsing any DSM-IV criteria calling for more research on the clinical relevance and classification of this subgroup. Furthermore, findings highlight the need for prevention and intervention measures that target subjects with specific socioeconomic and gambling-related risk factors.

Disordered gambling as defined by the Diagnostic and Statistical Manual of Mental Disorders and the South Oaks Gambling Screen: evidence for a common etiologic structure

In a previous article, we demonstrated in a large twin study that disordered gambling (DG), as defined by the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV), ran in families, that about half of the variation in liability for DG was due to familial factors, and that all of this was explained by shared genetic rather than shared environmental influences (Slutske, Zhu, Meier, & Martin, 2010). The purpose of the present study is to extend this work to include an alternative conceptualization of DG that is provided by the South Oaks Gambling Screen (SOGS) item set in order to (a) compare the magnitude of the familial resemblance obtained when using the two definitions of DG (based on the DSM-IV and the SOGS), (b) examine the extent to which the 2 definitions tap the same underlying sources of genetic and environmental variation, and (c) examine whether the same results will be obtained among men and women. The results of bivariate twin model-fitting analyses suggested that DG, as defined by the DSM-IV and the SOGS, substantially overlapped at the etiologic level among both men and women, which supports the construct validity of both the DSM and the SOGS conceptualizations of DG. This study highlights the utility of twin studies for appraising the validity of the diagnostic nomenclature.

Where did all the pathological gamblers go? Gambling symptomatology and stage of change predict attrition in longitudinal research

Attrition can introduce a systematic bias that can negatively affect validity (Cook and Campbell, Quasi-experimentation: design and analysis issues for field settings. Rand McNally, Chicago, 1979). Current longitudinal research in gambling, however, has generally overlooked the reasons for attrition. The current research examined the relationship between pathological gambling symptomatology, stage of change and attrition. Three hundred and seventy-nine participants were contacted 12 months after initially participating in a study on gambling for a follow-up session. Logistic regression revealed those in the contemplation and preparation stages of change reported higher levels of pathological gambling symptomatology and were more likely to drop out of the study compared to those in the precontemplation stage. As predicted, gambling symptomatology mediated the relationship between stages of change and attrition. The implication for longitudinal research on gambling as well as extant findings that have used this methodological approach is discussed.

Current challenges and future perspectives in the field of addiction psychiatry in Latin America

This paper provides a brief review of the addictions field in Latin America. Epidemiology, legal aspects, dual pathology, treatment, prevention and future directions are discussed. This increasing disease is one of the major contributors for mental health problems in the region. Efforts have been made in treatment and prevention but results and budgets are scarce. Dual pathology, new modalities such as injected heroin in countries such as Colombia, low coverage of programmes, training resources, research and publications are important challenges. The tendency to liberalize legal terms of use would require more effort for prevention and education. Based on relevant literature and a long and current experience in the area, the authors summarize this important theme.

Pathological gambling in treatment-seeking alcoholics: a national survey in France

AIMS

To estimate the prevalence of pathological gambling (pG) in people addicted to alcohol and drugs, particularly those with alcohol use disorders (AUDs), including new forms of gambling such as video and on-line games; and to update the socio-demographic profile of people suffering from both AUD and pG.

METHOD

A cross-sectional survey was conducted in 1 week of 2009 in 55 French addiction treatment centres, including all consecutive patients attending that centre, using an anonymous questionnaire which included a tool specific for pG screening, the DEBA-jeu questionnaire (Détection et Besoin d'Aide en regard du Jeu Excessif).

RESULTS

A total of 2790 patients entered the study. The most frequent reason for attending the Addiction Centres was AUD (77%). According to the DEBA test, 6.5% of the patients were pathological gamblers and 12% were subsyndromal gamblers. pG affected all age groups and did not decrease with abstinence from alcohol. pG was significantly associated with male sex [relative risk (RR) = 2.4; P < 0.001)] and, at a lower level of significance, with homelessness (RR = 1.52; P = 0.03) and unemployment (RR = 1.47; P = 0.04).

CONCLUSIONS

pG appears to be a common feature of the French people with alcohol and drug disorders. Apart from male sex, no parameter had discriminatory power sufficient to target pG screening on a specific subgroup. Therefore, any patient attending a centre for drug or AUD should be asked about his gambling. Moreover, clinical teams should be trained to treat this addiction.

A latent class analysis of DSM-IV pathological gambling criteria in a nationally representative British sample

This study identified empirically derived subtypes of gamblers based on the Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) diagnostic criteria for pathological gambling disorder (PGD). Data from the gamblers (n=5644) who participated in the 2007 British Gambling Prevalence Survey (BGPS) were analysed using latent class analysis. Common socio-demographic correlates of PGD were subsequently assessed across the classes. Three distinct groups or classes of gamblers emerged. The majority of the sample (88.9%) was assigned to a 'non-problematic gambler' class. A second 'preoccupied chaser' class contained a significant percentage of gamblers (9.7%) who reported symptoms such as a preoccupation with gambling and engaging in chasing loses. Approximately 1.4% of gamblers were classified into an 'antisocial impulsivist gambler' class. Males, non-Whites and smokers were all more likely to be preoccupied chasers or antisocial impulsivist gamblers, rather than non-problematic gamblers. The current findings revealed that the gambling subtypes identified in the 2007 BGPS largely differed in relation to the severity, rather than the type, of symptoms experienced. These findings present a useful and clinically meaningful typology of individuals with PGD that may be examined further in both research and clinical settings.

A survey of pharmacy students' experiences with gambling

OBJECTIVES

To assess gambling among pharmacy students using the South Oaks Gambling Screen (SOGS).

METHODS

Six hundred fifty-eight pharmacy students enrolled at Creighton University were surveyed to determine the extent and characteristics of their gambling.

RESULTS

Four hundred eighty-eight students (74.2%) participated (mean age was 26.6 years and 63.4% were female). Almost two-thirds (63.1%) gambled at least once during the past 12 months. Slightly more than 16% (80) of students were identified as "at-risk" (SOGS scores of 1 to 2). Another 5% (24) were likely to be problem gamblers (SOGS scores of 3 to 4), while 1% of students were identified as probable pathological gamblers (SOGS scores > or = 5). Students who gambled were significantly more likely than non-gamblers to be single males. Gamblers with a score > or = 1were significantly more likely to report gambling had affected their relationships with others, compared to casual gamblers.

CONCLUSIONS

Gambling is a common activity among pharmacy students. While the incidence of problem gambling is relatively small, the percentage of our students who may be at-risk for gambling-related problems is noteworthy.

The Interplay of Appraisals, Specific Coping Styles, and Depressive Symptoms Among Young Male and Female Gamblers

The present study assessed gambling appraisals and specific coping styles among 400 young male (n = 230) and female (n = 170) gamblers. Of particular interest was to determine whether gender variations in stress-related responses are associated with the degree of gambling pathology, depressive symptoms, and attitude to seeking treatment. Results showed that greater appraisals of threat, illusions of control, and negative outcome expectancies were associated with higher levels of gambling pathology, particularly among males. Further, among women, gambling propensity was associated with reduced social support seeking, whereas for men gambling pathology was primarily accounted for by increased use of wishful thinking. These coping strategies, combined with other internally oriented emotion-focused strategies, mediated the relation between gambling and depressive symptoms. Not surprisingly, more positive attitudes to treatment seeking were reported by those with a greater propensity to use problem-solving and support seeking coping efforts. The utility of assessing specific components that comprise a gambler’s stress-response is discussed.

[Pathological gambling and its consequences for public health]

The article aimed to characterize pathological gambling, showing the main consequences of this disorder. Bibliographic survey on this theme was conducted, covering both national and international literature. Publications whose main findings emphasized related prevalence, social and economic costs, gambling legalization and resulting impact on public health, were selected. High suicide rate, comorbidity with other psychiatric disorders, family and work problems, and illicit behavior were consequences reported. The prevalence of this disorder is higher in countries that have legalized gambling and in Brazil there is evidence of growth in the number of pathological gamblers. The development of national research is fundamental to define public policies that are adequate for the Brazilian context.

The performance of two pathological gambling screens in college students

The psychometric properties of two pathological gambling (PG) screening instruments, the South Oaks Gambling Screen (SOGS) and the Massachusetts Gambling Screen-DSM-IV subscale (MAGS), were explored in a sample of college students (N = 159). Participants completed the two screening instruments, a diagnostic interview for PG, the Gambling-Timeline Followback (G-TLFB), Gambling Self-Efficacy Questionnaire (GSEQ), and the Hopkins Symptom Checklist (HSCL). Both screening measures were found to have adequate internal consistency and were highly correlated with each other and the diagnostic interview. The screening measures demonstrated convergent and discriminant validity. Using the diagnostic interview as the criterion measure, the SOGS demonstrated better sensitivity in identifying PG college students than the MAGS. The MAGS demonstrated better specificity in identifying non-PG college students than the SOGS. The results of this study suggest that although neither measure is perfect in identifying PG college students, the SOGS is a more appropriate measure for screening purposes.

Does gender moderate associations among impulsivity and health-risk behaviors?

The present study explores the relations among gender, impulsivity and three health-risk behaviors relevant to young adults (tobacco use, alcohol problems and gambling problems) in a sample of 197 college-age individuals. We sought to determine whether impulsivity is associated with health-risk behaviors in the same ways for men and women. For tobacco use and gambling problems, men were at higher risk than women, and impulsivity was not significantly associated with higher risk. Higher levels of motor impulsivity in men accounted for a significant amount of the gender difference in risk for alcohol problems. That is, impulsivity as measured by the Barratt Impulsiveness Scale (version 11), mediated the association between gender and risk for alcohol problems. For impulsivity as measured by Stop Signal Reaction Time (i.e. response inhibition), gender moderated the association between impulsivity and alcohol problems. Specifically, lower levels of impulsivity were associated with greater risk for alcohol problems in both men and women, but the effect was stronger in men. We speculate that this seemingly paradoxical result might be the result of coping drinking to deal with negative affect associated with behavioral overcontrol. These findings suggest that prevention efforts might well focus on identifying individuals at high risk for alcohol problems, especially males, by assessing response inhibition.

Prevalence and correlates of lifetime disordered gambling in Cambodian refugees residing in Long Beach, CA

BACKGROUND

Research has suggested that disordered gambling is endemic to Cambodian refugees. Whereas earlier study of the prevalence and correlates of disordered gambling has relied on convenience sampling, this investigation used a subset of a sample representative of the largest Cambodian refugee community in the US.

METHODS

Face-to-face interviews assessing gambling disorder were conducted with a subsample of persons (N = 127) participating in a broader study of the mental health of this community.

RESULTS

13.9% of participants met screening criteria for lifetime disordered gambling, in contrast to previous research suggesting that prevalence rates may exceed 70%. After adjusting for a range of covariates, breadth of trauma exposure and marital status emerged as significant predictors of disordered gambling.

DISCUSSION

Given the myriad mental health challenges facing the Cambodian refugee community, these data indicate that scarce prevention and treatment resources may be more productively channeled toward addressing other mental health and social service needs.