High-risk Gamblers Research Articles

Risk Factors for Gambling Problems on Online Electronic Gaming Machines, Race Betting and Sports Betting.

Growth of Internet gambling has fuelled concerns about its contribution to gambling problems. However, most online gamblers also gamble on land-based forms, which may be the source of problems for some. Studies therefore need to identify the problematic mode of gambling (online or offline) to identify those with an online gambling problem. Identifying most problematic form of online gambling (e.g., EGMs, race betting, sports betting) would also enable a more accurate examination of gambling problems attributable to a specific online gambling form. This study pursued this approach, aiming to: (1) determine demographic, behavioral and psychological risk factors for gambling problems on online EGMs, online sports betting and online race betting; (2) compare the characteristics of problematic online gamblers on each of these online forms. An online survey of 4,594 Australian gamblers measured gambling behavior, most problematic mode and form of gambling, gambling attitudes, psychological distress, substance use, help-seeking, demographics and problem gambling status. Problem/moderate risk gamblers nominating an online mode of gambling as their most problematic, and identifying EGMs (n = 98), race betting (n = 291) or sports betting (n = 181) as their most problematic gambling form, were compared to non-problem/low risk gamblers who had gambled online on these forms in the previous 12 months (n = 64, 1145 and 1213 respectively), using bivariate analyses and then logistic regressions. Problem/moderate risk gamblers on each of these online forms were then compared. Risk factors for online EGM gambling were: more frequent play on online EGMs, substance use when gambling, and higher psychological distress. Risk factors for online sports betting were being male, younger, lower income, born outside of Australia, speaking a language other than English, more frequent sports betting, higher psychological distress, and more negative attitudes toward gambling. Risk factors for online race betting comprised being male, younger, speaking a language other than English, more frequent race betting, engaging in more gambling forms, self-reporting as semi-professional/professional gambler, illicit drug use whilst gambling, and more negative attitude toward gambling. These findings can inform improved interventions tailored to the specific characteristics of high risk gamblers on each of these online activities.

Prevention paradox logic and problem gambling: Does low-risk gambling impose a greater burden of harm than high-risk gambling?

Background and aims The aim of this paper is to examine the evidence and arguments in favor of prevention paradox (PP) logic in the context of problem gambling. Evidence from recent studies of gambling and the distribution of harm across lower and higher risk gamblers is reviewed to examine the contention that the absolute burden of harm is greater in low-risk (LR) gamblers than the problem gamblers.MethodsThe review examines a number of methodological and conceptual concerns about existing evidence in support of the PP.ResultsThe principal problems identified include the misclassification of LR gamblers; the use of binary scoring method that understates the frequency of harms in high-risk populations; a tendency to confuse behavior and harm; and the use of potentially overly inclusive definitions of harm with low thresholds of severity.Discussion and conclusionsThis paper makes a number of recommendations for enhancement of this area of research, including the use of clear definitions of harm and LR behavior and a greater focus on harm with material impacts on people’s quality of life.

Risky Decision Making in Neurofibromatosis Type 1: An Exploratory Study

BackgroundNeurofibromatosis type 1 (NF1) is a monogenic disorder affecting cognitive function. About one third of children with NF1 have attentional disorders, and the cognitive phenotype is characterized by impairment in prefrontally mediated functions. Mouse models of NF1 show irregularities in gamma-aminobutyric acid release and striatal dopamine metabolism. We hypothesized that youths with NF1 would show abnormal behavior and neural activity on a task of risk taking reliant on prefrontal-striatal circuits. MethodsYouths with NF1 (n = 29) and demographically comparable healthy control subjects (n = 22), aged 8 to 19 years, were administered a developmentally sensitive gambling task in which they chose between low-risk gambles with a high probability of obtaining a small reward and high-risk gambles with a low probability of obtaining a large reward. We used functional magnetic resonance imaging to investigate neural activity associated with risky decision making as well as age-associated changes in these behavioral and neural processes. ResultsBehaviorally, youths with NF1 tended to make fewer risky decisions than control subjects. Neuroimaging analyses revealed significantly reduced neural activity across multiple brain regions involved in higher-order semantic processing and motivation (i.e., anterior cingulate, paracingulate, supramarginal, and angular gyri) in patients with NF1 relative to control subjects during the task. We also observed atypical age-associated changes in neural activity in patients with NF1 such that during risk taking neural activity tended to decrease with age in control subjects, whereas it tended to increase with age in patients with NF1. ConclusionsFindings suggest that developmental trajectories of neural activity during risky decision making may be disrupted in youths with NF1.

Problem Gambling Among Urban and Rural Gamblers in Limpopo Province, South Africa: Associations with Hazardous and Harmful Alcohol Use and Psychological Distress.

Little is known about the mental health correlates of problem gambling in low- and-middle-income countries such as South Africa and whether these correlates vary by urbanicity. To address this gap, we examined mental health factors associated with problem gambling among gamblers in Limpopo Province, South Africa disaggregated by rural, peri-urban and urban location. A survey of gambling behaviour and mental health was conducted among 900 gamblers. Overall, 28.3% were at high risk and 38.1% were at moderate risk for problem gambling. For the entire sample, hazardous/harmful alcohol use was associated with almost twofold increased chance of being at moderate risk (AOR 1.83; 95% CI 1.08, 3.11) and almost sevenfold greater odds (AOR 6.93; 95% CI 4.03-11.93) of being at high risk for problem gambling. Psychological distress was associated with being at high risk for problem gambling only (AOR 1.18; 95% CI 1.14-1.22). After stratifying by urbanicity, hazardous/harmful alcohol use and psychological distress remained associated with high risk gambling across all locations. We found little knowledge of a free gambling helpline and other gambling services-particularly in less urbanised environments [χ(2) (2), 900=40.4; p<0.001]. These findings highlight the need to increase awareness of free helpline services among gamblers and to ensure gambling services include screening and treatment for common mental disorders.

Adolescent and adult risk-taking in virtual social contexts.

There is a paucity of experimental data addressing how peers influence adolescent risk-taking. Here, we examined peer effects on risky decision-making in adults and adolescents using a virtual social context that enabled experimental control over the peer “interactions.” 40 adolescents (age 11–18) and 28 adults (age 20–38) completed a risk-taking (Wheel of Fortune) task under four conditions: in private; while being observed by (fictitious) peers; and after receiving ‘risky’ or ‘safe’ advice from the peers. For high-risk gambles (but not medium-risk or even gambles), adolescents made more risky decisions under peer observation than adults. Adolescents, but not adults, tended to resist ‘safe’ advice for high-risk gambles. Although both groups tended to follow ‘risky’ advice for high-risk gambles, adults did so more than adolescents. These findings highlight the importance of distinguishing between the effects of peer observation and peer advice on risky decision-making.

Adaptive and maladaptive personality traits in high-risk gamblers.

Gambling Disorder (GD) is an addictive disorder resulting in significant impairment in occupational and social functioning. The aim of the present study was to investigate the relationship of GD risk to adaptive and maladaptive personality dimensions in a sample of nonreferred Italian gamblers. The authors found the risk for GD to show significant associations with the Openness and Conscientiousness scales of the Big Five Inventory (BFI); however, these effects were not significant after controlling for alcohol and drug use. GD risk showed significant associations with the Detachment and Antagonism domains of the Personality Inventory for DSM-5 (PID-5), as well as with the PID-5 facet scales of Hostility, Callousness, Deceitfulness, Manipulativeness, Irresponsibility, and (low) Rigid Perfectionism, even when controlling for alcohol and drug use. Maladaptive personality dispositions may serve as risk factors for pathological gambling, even beyond their impact on frequently concomitant problems with alcohol and other drugs.

How Availability and Accessibility of Gambling Venues Influence Problem Gambling: A Review of the Literature

How Availability and Accessibility of Gambling Venues Influence Problem Gambling: A Review of the Literature

The Clustering of Psychiatric Disorders in High-Risk Gambling Populations

The aims of this study were to examine the associations between psychiatric disorders and pathological gambling (PG) and the clustering of psychiatric disorders in high risk gambler populations. The sample comprised 140 regular gamblers who were recruited from the general public. A variety of self- report and semi structured questionnaires was administered, including the Mini International Neuropsychiatric Interview, The Personality Diagnostic Questionnaire-4th Edition, NORC DSM-IV Screen for Gambling Problems Self- administered and Problem Gambling Severity Index. Axis I and Axis II psychiatric disorders and personality disturbances were found to be more prevalent amongst pathological gamblers than other gamblers with the strongest differences observed for mood and anxiety-related disorders. Almost two-thirds of pathological gamblers reported both an anxiety or mood disorder in conjunction with another type of disorder. These differences between the gambling groups existed even after controlling for gender. The results highlight the high rates of co-morbidity in pathological gamblers in the community and the extent to which anxiety and mood disorders co-existing with other forms of pathology. These results highlight the significant challenges facing treatment services in the treatment of PG and the extent to which this should be treated as the primary disorder.

Neural Correlates of Anticipation Risk Reflect Risk Preferences

Individual risk preferences have a large influence on decisions, such as financial investments, career and health choices, or gambling. Decision making under risk has been studied both behaviorally and on a neural level. It remains unclear, however, how risk attitudes are encoded and integrated with choice. Here, we investigate how risk preferences are reflected in neural regions known to process risk. We collected functional magnetic resonance images of 56 human subjects during a gambling task (Preuschoff et al., 2006). Subjects were grouped into risk averters and risk seekers according to the risk preferences they revealed in a separate lottery task. We found that during the anticipation of high-risk gambles, risk averters show stronger responses in ventral striatum and anterior insula compared to risk seekers. In addition, risk prediction error signals in anterior insula, inferior frontal gyrus, and anterior cingulate indicate that risk averters do not dissociate properly between gambles that are more or less risky than expected. We suggest this may result in a general overestimation of prospective risk and lead to risk avoidance behavior. This is the first study to show that behavioral risk preferences are reflected in the passive evaluation of risky situations. The results have implications on public policies in the financial and health domain.

‘They are working every angle’. A qualitative study of Australian adults' attitudes towards, and interactions with, gambling industry marketing strategies

As gambling products have diversified so too have the ways in which the gambling industry has been able to target, reach and engage different sectors of the community. Limited research has explored the ways in which individuals conceptualize and respond to gambling marketing strategies. Semi-structured, qualitative interviews were conducted with 100 adults in Victoria, Australia, who had gambled at least once during the previous year. Participants described the multi-layered ways in which gambling was marketed and were concerned about the role of marketing in ‘normalizing’ gambling for some groups. Male participants felt ‘bombarded’ and ‘targeted’ by sports bet marketing. Most women and older men actively resisted gambling marketing strategies. Older women, younger men, moderate and high risk gamblers and those from low socio-economic backgrounds were particularly influenced by incentivization to gambling. This study highlights the complex ways in which different individuals interpret and respond to gambling industry marketing strategies.

Analysis of casino online gambling data in relation to behavioural risk markers for high-risk gambling and player protection

The Internet gambling industry has witnessed tremendous growth in recent years. Nonetheless, our understanding of Internet problem gambling behaviour remains in its infancy. In this paper we build on previous research analysing behavioural markers for high-risk Internet gambling using a new casino data set of active real money Internet gamblers. We assess the first month of play following registration using four behavioural markers: trajectory, frequency, intensity and variability. Our findings identify groups of gamblers who show signs of potentially risky behaviours, specifically gambling intensity and frequency. These gamblers also spend time gambling on slots Internet games. These findings provide a basis for using behavioural analysis to educate players about risks associated with gambling. We suggest a framework for how this can be implemented. Further research leading to the identification of risk factors for problem gambling using new methodologies and data sets will increase the clinical understanding of Internet problem gamblers.

Examining the predictive validity of low‐risk gambling limits with longitudinal data

To assess the impact of gambling above the low-risk gambling limits developed by Currie et al. (2006) on future harm. To identify demographic, behavioural, clinical and environmental factors that predict the shift from low- to high-risk gambling habits over time. Longitudinal cohort study of gambling habits in community-dwelling adults. Alberta, Canada. A total of 809 adult gamblers who completed the time 1 and time 2 assessments separated by a 14-month interval. Low-risk gambling limits were defined as gambling no more than three times per month, spending no more than CAN$1000 per year on gambling and spending less than 1% of gross income on gambling. Gambling habits, harm from gambling and gambler characteristics were assessed by the Canadian Problem Gambling Index. Ancillary measures of substance abuse, gambling environment, major depression, impulsivity and personality traits assessed the influence of other risk factors on the escalation of gambling intensity. Gamblers classified as low risk at time 1 and shifted into high-risk gambling by time 2 were two to three times more likely to experience harm compared to gamblers who remained low risk at both assessments. Factors associated with the shift from low- to high-risk gambling behaviour from time 1 to time 2 included male gender, tobacco use, older age, having less education, having friends who gamble and playing electronic gaming machines. An increase in the intensity of gambling behaviour is associated with greater likelihood of future gambling related harm in adults.

Neural Correlates of Pathological Gamblers Preference for Immediate Rewards During the Iowa Gambling Task: An fMRI Study

The Iowa Gambling Task (IGT) involves exploratory learning via rewards and penalties, where most advantageous task performance requires subjects to forego potential large immediate rewards for small longer-term rewards to avoid larger punishments. Pathological gambling (PG) subjects perform worse on the IGT compared to controls, relating to their persistence at high risk decisions involving the continued choice of potential large immediate rewards despite experiencing larger punishments. We wished to determine if neural processing of risk and reward within striatal and frontal cortex is associated with this behaviour observed in PG. Functional magnetic resonance imaging (fMRI) was used to assess brain activity in response to a computerized version of the IGT. Thirteen male PG subjects with no active comorbidities were compared to 13 demographically matched control subjects. In agreement with previous behavioural studies, PG subjects performed worse on the IGT and made more high-risk choices compared to controls, particularly after experiencing wins and losses. During high-risk gambling decisions, fMRI demonstrated that PG subjects exhibited relatively increased frontal lobe and basal ganglia activation, particularly involving the orbitofrontal cortex (OFC), caudate and amygdala. Increased activation of regions encompassing the extended reward pathway in PG subjects during high risk choices suggests that the persistence of PG may be due to the increased salience of immediate and greater potential monetary rewards relative to lower monetary rewards or potential future losses. Whether this over activation of the reward pathway is associated with the development of PG warrants further investigation.

Low Trait Self-Control in Problem Gamblers: Evidence from Self-Report and Behavioral Measures

Problems with self-control are seen as a key cause of problem gambling behavior. Yet, self-control is rarely studied directly in gambling studies. We demonstrated that self-report and behavioral measures (derived from the strength model of self-control) show lower trait self-control in problem gamblers. In Study 1, a sample of 2,208 undergraduate students from the University of Guelph, Canada (73% female, mean age = 19 years, SD = 4) completed a self-report measure of self-control strength. In Study 2, a sample of 296 University of Guelph students and staff (58% female, mean age = 19 years, SD = 2) completed multiple behavioral measures of self-control strength. Both studies demonstrated that, compared to lower-risk gamblers, higher-risk gamblers have relative trait self-control deficits.

The Inventory of Gambling Situations in problem and pathological gamblers seeking alcohol and drug abuse treatment.

Identifying situations in which individuals gamble may be important for developing or improving treatments, but few instruments exist for examining high-risk gambling situations. This study evaluated the factor structure of the Inventory of Gambling Situations (IGS), an instrument that assesses situations that may lead to gambling episodes. Individuals seeking alcohol and drug abuse treatment who were identified as problem or pathological gamblers (N = 283) completed the IGS, and principal component analysis revealed a 4-factor solution best fit the data; the factors represented items related to Negative Affect, Positive Affect, Gambling Cues, and Social Situations. Across the whole scale, Cronbach's alpha was 0.97, ranging from 0.83 to 0.96 for the four factors. IGS total scores correlated with other indices of gambling problems, including number of pathological gambling criteria endorsed and frequency and intensity of gambling. Race, education, and severity of psychiatric, drug, and alcohol problems were significantly predictive of some factor scores. Specifically, African Americans were more likely to gamble in response to Negative Affect situations than Caucasians, and education was inversely associated with wagering in response to Gambling Cues. Psychiatric symptoms were predictive of gambling in response to both Positive and Negative Affect situations and Gambling Cues. Severity of drug and alcohol problems were related to gambling in Social Situations. Results from this study indicate that the IGS has good psychometric properties and suggest areas in which intervention efforts may be tailored to prevent or treat gambling problems among individuals seeking substance abuse treatment.

Development and Psychometric Evaluation of a 10-Item Short Form Inventory of Gambling Situations

The Inventory of Gambling Situations (IGS-63; Turner and Littman-Sharp, Inventory of gambling situations users guide, 2006) is a 63-item measure of high-risk gambling situations. It assesses gambling across 10 situational subscales that load onto two higher-order factors: negative and positive situations (Stewart et al. Psychology of Addictive Behaviors, 22:257-268, 2008). While the IGS-63 has excellent psychometric properties (Littman-Sharp et al., The Inventory of Gambling Situations: Reliability, factor structure, and validity (IGS Technical Manual), in press) its length may preclude its use in time-limited contexts. The purpose of this study was to develop and validate a 10-item short-form of the IGS (IGS-10). Each IGS-10 item reflects one of the ten subscale categories from the IGS-63, with two items from the original subscales included as examples for each IGS-10 item. The IGS-10 was administered to 180 undergraduate gamblers along with the IGS-63 and the Problem Gambling Severity Index (PGSI; Ferris and Wynne, Canadian Problem Gambling Index: Final report, 2001). IGS-10 items showed convergent validity with the corresponding IGS-63 subscales (r's=.60-.73). Principal components analysis of the IGS-10 revealed two factors: negative (α=.84) and positive (α=.85). PGSI scores correlated significantly with all IGS-10 items (r's=.33-.58) and with both IGS-10 higher-order subscales (r's=.66 [negative] and .49 [positive]), supporting the criterion validity of the IGS-10. Since minimal information is lost when using the IGS-10, the short form may prove particularly useful when respondent burden prevents using the full IGS-63.

Adolescent risky decision-making: Neurocognitive development of reward and control regions

Recent models hypothesize that adolescents' risky behavior is the consequence of increased sensitivity to rewards in the ventral medial (VM) prefrontal cortex (PFC) and the ventral striatum (VS), paired with immature cognitive control abilities due to slow maturation of the dorsal anterior cingulate cortex (ACC) and lateral PFC. We tested this hypothesis with fMRI using a gambling task in which participants chose between Low-Risk gambles with a high probability of obtaining a small reward (1 Euro) and High-Risk gambles with a smaller probability of obtaining a higher reward (2, 4, 6, or 8 Euro). We examined neural responses during choice selection and outcome processing in participants from 4 age groups (pre-pubertal children, early adolescents, older adolescents and young adults). High-Risk choices increased with rewards for all ages, but risk-taking decreased with age for low reward gambles. The fMRI results confirmed that High-Risk choices were associated with activation in VMPFC, whereas Low-Risk choices were associated with activation in lateral PFC. Activation in dorsal ACC showed a linear decrease with age, whereas activation in VMPFC and VS showed an inverted U-shaped developmental pattern, with a peak in adolescence. In addition, behavioral differences in risk-taking propensity modulated brain activation in all age groups. These findings support the hypothesis that risky behavior in adolescence is associated with an imbalance caused by different developmental trajectories of reward and regulatory brain circuitry.

How do gamblers start gambling: identifying behavioural markers for high-risk internet gambling

The goal of this study is to identify betting patterns displayed during the first month of actual Internet gambling on a betting site that can serve as behavioural markers to predict the development of gambling-related problems. Using longitudinal data, k-means clustering analysis identified a small subgroup of high-risk gamblers. Seventy-three percent of the members of this subgroup eventually closed their account due to gambling-related problems. The characteristics of this high-risk subgroup were as follows: (i) frequent and (ii) intensive betting combined with (iii) high variability across wager amount and (iv) an increasing wager size during the first month of betting. This analysis provides important information that can help to identify potentially problematic gamblers during the early stages of gambling-related problems. Public health workers can use these results to develop early interventions that target high-risk Internet gamblers for prevention efforts. However, one study limitation is that the results distinguish only a small proportion of the total sample; therefore, additional research will be necessary to identify markers that can classify larger segments of high-risk gamblers.

A Taxpayers' Perspective: Re-engineering California's State Budget for Economic Growth

THE CALIFORNIA Journal of Politics & Policy Commentary A Taxpayers’ Perspective: Re-Engineering California’s State Budget for Economic Growth Teresa Casazza* California Taxpayers’ Association Public finance in California is in grave turmoil. A se- vere recession took its toll in unprecedented job losses, re- ducing state and local revenues while increasing welfare caseloads and other social service costs. While economic difficulty can be a temporary problem, mounting public spending obligations have been burdening state and local government budgets long before this recession began. For too many years, California has been trying to do too much for too many people without enough money to www.bepress.com/cjpp Volume 1, Issue 2 , 2009 sustain it. Now that we are facing a $24 billion deficit, it is time to take a serious look at priorities and to find new ways to deliver better vital services in a more cost-effec- tive manner. The status quo is no longer acceptable. Every state program needs to be accountable for every tax dollar it consumes. The California Taxpayers’ Association urges state leg- islators, the governor, and local elected officials to take these actions: • Avoid new taxes and fees, while keeping in mind that the largest and most dramatic revenue opportunity for the state is revenue growth from an improved economy. Higher taxes are high-risk gambles. Particularly risky are split roll property taxes, various ways to tax high-income investors in the California economy, and other punitive taxes that target job creators. *Teresa Casazza is president of the California Taxpayers’ Association, a nonpartisan, nonprofit organization formed in 1926 to oppose unnecessary taxes and advocate for government efficiency.

Anticipatory affect: neural correlates and consequences for choice.

'Anticipatory affect' refers to emotional states that people experience while anticipating significant outcomes. Historically, technical limitations have made it difficult to determine whether anticipatory affect influences subsequent choice. Recent advances in the spatio-temporal resolution of functional magnetic resonance imaging, however, now allow researchers to visualize changes in neural activity seconds before choice occurs. We review evidence that activation in specific brain circuits changes during anticipation of monetary incentives, that this activation correlates with affective experience and that activity in these circuits may influence subsequent choice. Specifically, an activation likelihood estimate meta-analysis of cued response studies indicates that nucleus accumbens (NAcc) activation increases during gain anticipation relative to loss anticipation, while anterior insula activation increases during both loss and gain anticipation. Additionally, anticipatory NAcc activation correlates with self-reported positive arousal, whereas anterior insula activation correlates with both self-reported negative and positive arousal. Finally, NAcc activation precedes the purchase of desirable products and choice of high-risk gambles, whereas anterior insula activation precedes the rejection of overpriced products and choice of low-risk gambles. Together, these findings support a neurally plausible framework for understanding how anticipatory affect can influence choice.