Internet‐based CBT intervention for gamblers in Finland: Experiences from the field

From September 2007 to May 2011 a total of 471 participants (325 males and 146 females) signed up for an 8‐week Internet‐based cognitive behavioral therapy offered for gamblers in Finland. Sixty‐four percent of the participants were pathological gamblers (PGs) (NODS 5> points), 14% were problem gamblers (NODS 3–4 points) and 10% were at risk of gambling problems (NODS 1–2 points). Two hundred and twenty four participants completed the treatment and after the treatment period significant changes were found in the following variables: gambling related problems (NODS), gambling urge, impaired control of gambling, alcohol consumption (AUDIT‐C), social consequences, gambling‐related cognitive erroneous thoughts and depression (MARD‐S). In this sample co‐morbid alcohol consumption was stronger among males. The main finding of this study was that the onset age of gambling was associated with a greater amount of gambling‐related cognitive erroneous thoughts.     

Association of pathological gambling with depression in Scotland

Is most research concerning gambling and depression has been conducted on clinical populations, the present study examined the relationship between gambling and depression across a large sample in Scotland in higher education and the community. A questionnaire-based cluster design involved the distribution of the South Oaks Gambling Screen and the Centre for Epidemiologic Studies Depression Scale mainly to students and staff of higher educational establishments, with small community and gambling samples also included. Thirty-seven colleges and universities across Scotland participated in the research, with a sample of 2259 people aged sixteen years of age or over (M = 28.9 yr., SD = 13.4) being obtained. It was found that past-year probable pathological gamblers had significantly higher depression than problem gamblers, nonproblem gamblers, and nongamblers. However, when probable pathological gamblers who had sought treatment were omitted from the analysis, the nontreatment-seeking probable pathological gambling group no longer had significantly higher depression than the problem gambling group. Female problem and probable pathological gamblers had particularly high depressive symptomatology, suggesting co-morbid depression may be a prominent feature of problematic female gambling.     

Gambling Sponsorship and Advertising in British Football: A Critical Account

ABSTRACT

Problem gambling is a growing public health issue in the UK. In this paper, we argue that football plays a problematic role in the promotion and normalisation of gambling. Given that sport broadcasts offer gambling (and alcohol) companies a loophole to avoid the post-watershed guidelines, children and young people are also exposed. By marketing gambling in general and to children in particular, football contributes to an increase in the overall ‘amount’ of gambling in society. In turn, this contributes to an increase in the prevalence of problem gambling (including gambling disorder) and all the associated harms. Furthermore, we argue that a significant amount of gambling profits come from problem gamblers. Therefore, football benefits from, and contributes to, the addictive consumption of gamblers.     

Trauma history and severity of gambling involvement among horse-race gamblers in a South African gambling setting

The purpose of this study was to ascertain the frequency of gambling involvement and the prevalence of problem gambling among horse race gamblers and to discover whether problem gambling in this sample is associated with a history of trauma. Among a sample of 266 South African horse-race gamblers (94% men and 6% women, Mage 46.8 yr., SD = 13.9, range 18-85 years), 31.2% were classified as probable pathological gamblers and 19.9% with problem gambling. Major weekly gambling activities included racetrack betting (82%), purchase of lottery tickets or scratch tickets (35%), purchase of sports lottery tickets (23%), and using casino type games (18%). Trauma history was significantly associated with gambling severity.     

Social Deviancy and Suicidal Behavior

Abstract

In this study lottery gambling behavior of 288 American college students was examined. Although most students were infrequent gamblers, we found that student lottery gambling was related to having parents and friends who were lottery gamblers. Students who were frequent lottery gamblers were more likely to participate in other forms of gambling and to have begun gambling at younger ages than less frequent gamblers. Locus of control was related to more frequent gambling among parents and only marginally related to more frequent lottery play among students. Discriminant analysis using parental gambling, peer gambling, games played, sex, and locus of control could predict frequency of lottery playing for 72% of gamblers and nongamblers.     

Personality disorders and pathological gambling: a review and re-examination of prevalence rates

The current study reviews and reexamines the association between pathological gambling and personality disorders (PDs). To date, the majority of investigations have examined the prevalence of PDs in a single group of treatment-seeking pathological gamblers (PGs); very few of these studies included a comparison group, and even fewer compared PGs to nonpathological gamblers who, in contrast to nongamblers, resemble PGs in their attraction to and engagement in gambling behavior. The current study included a sample composed of nontreatment-seeking pathological gamblers and a comparison group of nonpathological gamblers (NPGs); these participants completed a self-report instrument (SCID-II/PQ) and were administered a structured clinical interview SCID-II) designed to assess PDs. Compared to the SCID-II, the SCIDII/PQ produced significantly higher PD prevalence rate estimates and symptom endorsements. Although the pattern of specific PD prevalence and symptom endorsement varied somewhat across the instruments, PGs consistently displayed significantly higher levels of borderline PD than NPGs; this pattern endured even after controlling for Axis I disorders and overlap among Axis II PDs.     

Impulsivity facets and cognitive distortions associated with problem gambling: Differences between ADHD and non-ADHD gamblers

ObjectiveTo compare the association between (1) impulsivity facets or cognitive distortions, and (2) problem gambling between male gamblers with versus without self-reported Attention-Deficit/Hyperactivity Disorder (ADHD).MethodIn 287 male gamblers recruited online, we assessed problem gambling (South Oaks Gambling Screen; cut-off ≥ 3), Adult ADHD Self-report Scale-V1.1 (ADHD), impulsivity facets (UPPS Impulsive Behavior Scale-short version) and gambling-related cognitions (Gambling-Related Cognitions Scale).ResultsThe prevalence of self-reported ADHD was 21.6%. In both ADHD and non-ADHD groups, problem gambling was associated with negative urgency, positive urgency and the same cognitive distortions. Sensation seeking and lack of premeditation were associated with problem gambling, but only in non-ADHD gamblers (significant interaction effect).ConclusionDifferent impulsivity facets, but not different cognitive distortions, are associated with problem gambling in male gamblers with or without ADHD. Emotion dysregulation (positive and negative urgency) and cognitive distortions are involved in both groups, but sensation seeking and lack of premeditation may be specific to non-ADHD problem gamblers.     

Pilot Study of a Personalized Feedback Intervention for Problem Gamblers

A pilot study was conducted of a personalized feedback intervention for problem gamblers. Respondents (N = 61) were recruited from an ongoing gambling research study to take part in another study to help us “develop and evaluate self-help materials for gamblers.” Respondents were randomly assigned to receive a personalized feedback summary or to a waiting list control. At 3-month follow-up (80.3% follow-up rate, N = 49), after controlling for baseline demographic characteristics and gambling severity, respondents in the feedback condition displayed some evidence that they were spending less money on gambling than those in the control condition. Further, ratings of the usefulness of the feedback summary were positive and most recipients (96%) recommended that they be made available to other gamblers interested in evaluating or modifying their gambling. Given these promising pilot results, a full-scale evaluation of these personalized feedback materials would appear justified. An online version of the intervention is now also available at www.CheckYourGambling.net.     

Subtyping pathological gamblers on the basis of affective motivations for gambling: relations to gambling problems, drinking problems, and affective motivations for drinking

Pathological gamblers who drink when gambling (n=158; 77% men; mean age=36.0 years) completed the Inventory of Gambling Situations (IGS) and gambling and drinking criterion measures. Principal components analysis on the IGS subscales revealed negative (e.g., Unpleasant Emotions) and positive (e.g., Pleasant Emotions) gambling situation factors. Subjecting IGS factor scores to cluster analysis revealed three clusters: (a) enhancement gamblers, with low negative and high positive factor scores; (b) coping gamblers, with very high negative and high positive factor scores; and (c) low emotion regulation gamblers, with low negative and positive factor scores (59%, 23%, and 18% of the sample, respectively). Clusters were validated with a direct measure of gambling motives. Additional validity analyses showed that coping gamblers scored higher than the other groups on a variety of different gambling activities, gambling problems, drinking frequency, drinking problems, and coping drinking motives, whereas low emotion regulation gamblers scored lower than the other groups on gambling frequency, gambling problems, drinking quantity, and enhancement drinking motives. The findings validate this empirical approach to subtyping gamblers and suggest consistency of motives across addictive behaviors.     

Internet gambling, substance use, and delinquent behavior: an adolescent deviant behavior involvement pattern

Internet gambling among adolescents is a growing phenomenon that has received little attention to date. This study examines associations between Internet gambling and the severity of gambling, substance use (SU), and delinquent behavior among 1,870 Quebec students aged 14 to 18. The results show a higher proportion of Internet-gambling (IG) students reporting problematic substance use and delinquency, compared with nongamblers (NG) and non-Internet gamblers (NIG). Furthermore, a higher proportion of at-risk and probable pathological gamblers are found among IG compared with NIG. A moderating effect (Baron & Kenny, 1986) of the gambler categories (NIG, IG) was found in the relationship between the associated problems and the severity of gambling. Among IG, the severity of delinquency and of substance use contributes to explaining gambling severity whereas, among NIG, the severity of delinquency is the only factor that significantly contributes to such an explanation. Discussion of the results is based on Jessor, Donovan, and Costa's (1991) general deviance syndrome theory.     

Problem Gambling Features and Gendered Gambling Domains Amongst Regular Gamblers in a Swedish Population-Based Study

This study aimed to investigate, from a gender perspective, how different features of problem gambling present in men and women who gamble regularly in Sweden were distributed in four domains based on gambling type (chance or strategy) and setting (public or domestic). Problem gambling features were based on the nine items in the Problem Gambling Severity Index (PGSI). It was hypothesized that men and women gamble in different domains. Further, it was hypothesized that male gamblers overall experienced more problems with gambling than female gamblers, although in the same domains they would report the same level of problems. A further hypothesis predicted that regular female gamblers would experience more health and social problems and men would experience more financial difficulties. Interviews with a subsample of gamblers (n?=?3191) from a Swedish nationally representative sample (n?=?8179) was used to examine how features of problem gambling correspond with gender and the domains. Only the first hypothesis was fully supported. Men were more likely to participate in forms of gambling requiring strategy in a public setting, and women were more likely to participate in chance-based gambling in a domestic setting. Male and female gamblers had similar levels of problem gambling in the bi-variate analysis, but if controlling for age and gambling in multiple domains, women were more at risk than men. Additionally, men and women presented similar health and economic situations. The differences between male and female gamblers in Sweden have implications for research and prevention.     

Is control a viable goal in the treatment of pathological gambling?

According to a report of National Gambling Impact Study Commission (National Gambling Impact Study Commission (1999). Final report. Washington, DC: Government Printing Office.), 97% of problem gamblers in the United States do not seek treatment. Within the small proportion of problem gamblers who enter into treatment, a high percentage drops out. Despite the fact that some researchers argue against abstinence as the only acceptable treatment goal and that regaining control over gambling behaviour appears to be possible for some pathological gamblers (PG), abstinence has been the only gambling intervention treatment goal. The primary goal of this study was to verify whether controlled gambling is a viable goal for pathological gamblers. The second goal was to identify the characteristics that predicted a successful outcome for treatment with a controlled gambling goal. Eighty-nine PGs were enrolled in cognitive-behavioural treatment aimed at controlled gambling. Six and twelve month follow-ups were conducted in order to evaluate the maintenance of therapeutic gains and to identify significant predictors of successful controlled gambling. Results showed that using the intent-to-treat procedure, 63% had a score of 4 or less on the DSM-IV at the end of treatment. That proportion was 56% and 51% at the 6- and 12-month follow-ups. If we retain only those who completed the treatment, these proportions increased to 92%, 80% and 71% at post-treatment, 6- and 12-month follow-ups, respectively. On the majority of the measures, significant improvements were found at post-treatment and the therapeutic gains were maintained at the 6- and 12-month follow-ups. However, few variables were identified to predict who would benefit from control rather than abstinence. The clinical and philosophical implications of these results are discussed in this paper.     

Characterization of controlled gamblers and pathological gamblers using the social representation theory

Introduction

In industrialized countries, gambling disorder tends to become a major issue. The use of the social representation theory provides clues for a better understanding of pathological gamblers.

A taxometric analysis of actual Internet sports gambling behavior

This article presents findings from the first taxometric study of actual gambling behavior to determine whether we can represent the characteristics of extreme gambling as qualitatively distinct (i.e., taxonic) or as a point along a dimension. We analyzed the bets made during a 24-month study period by the 4,595 most involved gamblers among a cohort of 48,114 people using an Internet service to gamble on sporting events. We applied two taxometric procedures (i.e., MAMBAC and MAXCOV) to three indicators of betting behavior: total money lost, total number of bets, and total money wagered. The results fail to provide support for the view that the most involved Internet sports gamblers include a distinct category of gamblers. More research is necessary to clarify the similar features of recreational and extreme gamblers and the dimensions that scientists can use to measure these behaviors. Finally, we discuss the implications of these findings for clinical, research, and public policy activities.     

Characteristics of problem gamblers 56 years of age or older: a statewide study of casino self-excluders

Gambling among older adults appears to be increasing, though little is known about the characteristics of older adult problem gamblers. The purpose of this study was to compare older adults to younger and middle-aged adults in a cohort of problem gamblers participating in a state-administered casino self-exclusion program. Self-reported problem gamblers (N = 1,601) who voluntary banned themselves from Missouri casinos from 2001 to 2003 were categorized by age as younger adults (ages 21 to 35; n = 490), middle-aged adults (ages 36 to 55; n = 950), and older adults (ages 56 to 79; n = 161), and were compared with respect to demographic variables, gambling participation, and reasons for self-exclusion. Older adult self-excluders typically began gambling in midlife, experienced gambling problems around age 60, reported preferences for nonstrategic forms of gambling, and identified fear of suicide as the primary reason for self-excluding. Implications for intervention, prevention and treatment are discussed. (PsycINFO Database Record (c) 2008 APA, all rights reserved).     

Pathological gambling and personality disorders: a pilot-study with the MCMI-II

In this paper, the most frequent personality disorders related to pathological gambling are described. A sample of 50 pathological gamblers, who were assessed with the MCMI-II before treatment, and of 50 normative subjects from general population with the same demographic features (age, sex and socioeconomic level) was selected. According to the results, the 40% of clinical sample (versus the 14% of normative sample) showed at least one personality disorder. The most prevalent one was the Narcissistic (32%), followed by the Antisocial and Passive-Aggressive (16% each one of them). Furthermore, the gamblers with personality disorders presented an average of 2.2 disorders and tended to be more impulsive. Likewise pathological gamblers abused of alcohol, showed a mild anxiety and were not so adapted to everyday life as much as the control group. Finally, implications of this study for clinical practice and future research in this field are commented upon.     

Pathological Women Gamblers: Gender-Related Aspects of Control

This study examines the control exhibited by pathological women gamblers over their lives and their surroundings, and how this is governed by their perception of their gender role and socio-cultural expectations of them as women. Seventeen pathological women gamblers (13 of whom were mothers) were recruited from three addiction treatment centers in Israel, and participated in semi-structured interviews. Three central themes emerged during analysis: maintaining control over the gender roles—putting child raising and housekeeping duties first despite their gambling habits; control over the choice of gambling venue—gambling far from their home, or where they knew the owners; and moral control—steering clear of immoral behaviors in spite of their addiction to gambling. Further analysis reveals how pathological women gamblers who are also mothers make rational choices that help them juggle between their gender roles and gambling, to minimize the social costs that might be incurred by their gambling habit. Moreover, presenting the gambling behavior as more moral than theft or prostitution enabled them to normalize their behavior. The study’s findings show how the decisions and choices made by the women in this study are shaped by the socio-cultural context in which they are made.     

Episodic chasing in pathological gamblers using the Iowa gambling task

"Chasing ones losses" is a key symptom among pathological gamblers (PGs). This study focuses on quantitative differences in episodic chasing (i.e., sequences of disadvantageous decisions within a single gambling session) between PGs and non-pathological gamblers (NPGs). We compared 61 PGs and 39 NPGs on the Iowa Gambling Task (IGT) and the Zuckerman Sensation Seeking Scale (SSS). The PGs showed significantly more chasing and had significantly poorer decision-making strategies than NPGs, particularly among males (F = 4.52, p < 0.05). Random players were significantly less sensation seeking than advantageous and disadvantageous (i.e., chasing) players, but there was no interaction with group or gender. The results suggest that quantifiable within-session gambling behavior holds important implications for detecting underlying vulnerabilities to gambling pathology.     

Psychological Factors that Promote and Inhibit Pathological Gambling

This paper describes qualitative data regarding psychological factors that may affect gambling behavior among treatment-seeking pathological gamblers. Participants (n = 84) diagnosed with pathological gambling were treated in a clinical trial examining the efficacy of cognitive behavioral therapy (CBT). Qualitative data were collected from participants during each of 8 structured CBT sessions. Specific gambling-related psychological factors that were assessed include triggers, consequences, high-risk situations, craving experiences, assertiveness skills, cognitive distortions, and coping strategies. The most commonly reported triggers for gambling were lack of structured time and negative emotional state, which were similar to the high-risk times for gambling. The most frequently listed positive consequences of gambling were enjoyment associated with winning and use of gambling as an escape. Negative consequences of gambling included depressed mood, financial problems, and conflict with family. Coping strategies changed during treatment, as participants reported relying less upon avoidance and distraction, and became better able to utilize support networks and cognitive coping skills. These data are important to better understand the factors associated with the development, maintenance, and cessation of pathological gambling.