Non-pathological Gamblers Research Articles

Association of cognitive distortions with problem and pathological gambling in adult male twins

Treatment studies suggest that gambling-related irrational beliefs and attitudes (i.e., cognitive distortions (CDs)) contribute to the risk for problem gambling behavior. In a community sample of men, we investigated the associations among lifetime gambling-related CDs, psychiatric disorders other than pathological gambling , and problem gambling severity. Subjects were 1354 members of the Vietnam Era Twin Registry. Problem gambling and gambling-related CDs were derived from a 2002 interview using the National Opinion Research Center DSM-IV Screen for Gambling Problems (NODS). Exploratory factor analysis was performed with the 12 CD items to identify an underlying construct. Generalized linear models were computed to test for associations among CDs, psychiatric disorders other than pathological gambling, and gambling problem severity. Co-twin control analyses of monozygotic twin pairs discordant for problem gambling severity adjusted for genetic and shared environmental influences. Twelve CD items related to one underlying CD construct. After adjustment for lifetime psychiatric disorders, pathological gambling symptoms were positively associated with higher CD scores. Pathological gambling symptoms remained significantly associated with CD scores after controlling for genetic and shared environmental influence. These results provide empirical support for an association between gambling-related CDs and gambling problem severity, even after controlling for genetic and shared environmental influences and non-pathological gambling psychiatric disorders. Public health messages and therapeutic interventions that reinforce the randomness of gambling and draw attention to distorted thinking may prevent the development of problem gambling and improve treatment outcomes.

Development and psychometric evaluation of a three‐dimensional Gambling Motives Questionnaire

This study was designed to develop and evaluate a self-report measure of gambling motives. Participants A community-recruited sample of 193 gamblers (70% male; mean age = 35.5 years) were selected to fill two groups according to scores on the South Oaks Gambling Screen: probable pathological gamblers (PPG; n = 154) and non-pathological gamblers (NPG; n = 39). Participants completed a novel 15-item measure of gambling motives called the Gambling Motives Questionnaire (GMQ), which was modeled after the original Drinking Motives Questionnaire, as well as a variety of gambling behavior and problem criterion measures. An exploratory principal components analysis revealed three intercorrelated factors tapping enhancement (ENH), coping (COP), and social (SOC) motives, respectively. Each GMQ subscale showed good internal consistency (alphas > 0.80). The PPG group scored higher on all three scales than the NPG group, with larger differences for ENH and COP. In line with the clinical literature, PPG women scored higher than PPG men on the COP subscale but also, unexpectedly, on the SOC subscale. In concurrent validity analyses, ENH consistently predicted greater gambling behavior, and COP and ENH consistently predicted more severe gambling problems. With gambling behavior levels controlled, only COP remained a significant predictor of gambling problem severity. Finally, gender interacted with gambling motives in predicting gambling problem severity: COP predicted gambling problems more strongly in women, whereas ENH predicted gambling problems more strongly in men. The GMQ appears to be a promising tool for both research and clinical applications with problem gamblers.

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.

Personality Traits and Disorders in Pathological Gamblers versus Normal Controls

Aims: To establish the personality traits and disorders of pathological gamblers in treatment by means of a descriptive cross-sectional study of two prospective matched-pair cohorts: 50 pathological gamblers versus a control group of 50 normal volunteers (non-patient and non-pathological gamblers). All the pathological gamblers of the sample followed treatment as out-patients in the province of Valencia (Spain-EU). Recruitment period: January-May 2004. Measure instruments: South Oaks Gambling Screen, Barratt Impulsivity Scale, Sensation Seeking Scale, and Structured Clinical Interview for Personality Disorders of Axis II of DSM-IV. Findings and conclusions: Male pathological gamblers go more often to health and social care facilities. Pathological gamblers prefer to play slot machines, present a higher prevalence of personality disorders, most of them belonging to cluster B, are more impulsive and higher sensation seekers than the controls. There are no linear relationships between the severity of pathological gambling and the traits of impulsivity and sensation seeking respectively.

Examining DSM-IV Criteria for Pathological Gambling: Psychometric Properties and Evidence from Cognitive Biases

We examined the DSM-IV criteria for pathological gambling as assessed with the DSM-IV-based Diagnostic Interview for Gambling Severity (DIGS; Winters, Specker, & Stinchfield, 2002). We first analyzed the psychometric properties of the DIGS, and then assessed the extent to which performance on two judgment and decision-making tasks, the Georgia Gambling Task (Goodie, 2003) and the Iowa Gambling Task (Bechara, Damasio, Damasio, & Anderson, 1994), related to higher reports of gambling pathology. In a sample of frequent gamblers, we found strong psychometric support for the DSM-IV conception of pathological gambling as measured by the DIGS, predictive relationships between DIGS scores and all cognitive performance measures, and significant differences in performance measures between individuals with and without pathological gambling. Analyses using suggested revisions to the pathological gambling threshold (Stinchfield, 2003) revealed that individuals meeting four of the DSM-IV criteria aligned significantly more with pathological gamblers than with non-pathological gamblers, supporting the suggested change in the cutoff score from five to four symptoms. Discussion focuses on the validity of the DSM-IV criteria as assessed by the DIGS and the role of cognitive biases in pathological gambling.

Pathological gambling and the five-factor model of personality

The goal of this investigation was to examine the personality differences between non-treatment seeking pathological gamblers (PGs) and non-pathological gamblers (NPGs) using the domain and facet traits of the five-factor model of personality (FFM), as measured by the NEO PI-R. Compared to NPGs, PGs scored significantly higher on the neuroticism domain and significantly lower on the conscientiousness domain. Significant differences between PGs and NPGs also emerged for three of four FFM facet traits associated with impulsivity, with PGs scoring higher on impulsiveness and lower on self-discipline and deliberation facets. Both PGs and NPGs had equally high scores (relative to the norm) on excitement-seeking, the fourth facet associated with impulsivity, suggesting that excitement-seeking characterizes gambling behavior rather than pathological gambling. The present findings suggest that the overall personality profile of the PG is one that combines high impulsivity with emotional vulnerability. Importantly, the results also suggest that excitement-seeking, a personality construct akin to sensation-seeking, may not be a specific marker of PG but rather a characteristic common to all those who gamble.

The Gamblers' Temperament and Character Inventory (TCI) Personality Profile

In a cross-comparison study, the Cloninger's Temperament and Character Inventory (TCI) personality profile was administered to 28 probable pathological gamblers (PPGs), 32 nonpathological gamblers (non-PGs), and 65 controls. As a screening device, the validated Italian version of the South Oak Gambling Screen was administered to all subjects. Novelty Seeking (NS) values were higher in PPGs in comparison with both non-PGs (p <. 05) and controls (p <. 001). PPGs showed lower Self-Directedness (SD) and Cooperativeness (CO) values with respect to both non-PGs (p <. 05 and p =. 001, respectively) and controls (p <. 001 and p =. 001, respectively). The subsamples of PPGs reporting either a current substance misuse condition or a parental involvement in gambling/substance misuse showed higher NS (p =. 01) and lower CO (p =. 005) values than the remaining PPGs. A duration of problem gambling in excess of 20 years was associated with lower (p =. 001) CO values. Specific temperamental (NS) and character (SD; CO) dimensions differentiated PPGs from both non-PGs and controls; assessment of personality profile with the TCI may identify at-risk social gamblers.

Divergent Validity of Measures of Cognitive Distortions, Impulsivity, and Time Perspective in Pathological Gambling

The present study assessed the divergent validity of several self-report and objective behavioral measures for assessing pathological gambling using three samples divided by South Oaks Gambling Scale score [Lesieur, & Blume (1987). American Journal of Psychiatry, 144, 1184-1188]: pathological gamblers, potential pathological gamblers, and non-pathological gamblers. Self-report measures included the Gamblers' Beliefs Questionnaire [GBQ; Steenbergh, Meyers, May, & Whelan (2002). Psychology of Addictive Behaviors, 16, 143-149], the Gambling Passion Scale [GPS; Rousseau, Vallerand, Ratelle, Mageau, & Provencher, (2002). Journal of Gambling Studies, 18, 45-66], the Eysenck Impulsivity Questionnaire [EIQ; Eysenck, & Eysenck (1978). Psychological Reports, 43, 1247-1255], and the Stanford Time Perspective Inventory [STPI; Zimbardo, & Boyd (1999). Journal of Personality and Social Psychology, 77, 1271-1288]. Behavioral tasks included the delay discounting task [Madden, Petry, Badger, & Bickel (1997). Experimental & Clinical Psychopharmacology, 5, 256-263] and the Future Time Perspectives [FTP; Wallace (1956). Journal of Abnormal Psychology, 52, 240-245]. The GBQ, GPS, Impulsivity subscale of the EIQ, and DDT all exhibited robust divergent validity, however, neither measure of time perspective discriminated between groups. Applications of these findings to etiological research and clinical contexts are discussed.

Convergent validity of measures of cognitive distortions, impulsivity, and time perspective with pathological gambling.

The present study investigated the convergent validity of the Gamblers' Beliefs Questionnaire (GBQ), Gambling Passion Scale (GPS), Eysenck Impulsivity Questionnaire (EIQ), and Stanford Time Perception Inventory (STPI) in reference to pathological gambling. The authors recruited 105 undergraduates representing categories of pathological gamblers, potential pathological gamblers, and nonpathological gamblers and administered the measures under neutral conditions. Both subscales of the GBQ and GPS and the Impulsivity subscale of the EIQ exhibited strong convergent validity, whereas the STPI showed weaker correspondence with symptoms of pathological gambling. Applications and limitations of these findings are discussed.

Heart rate increase to alcohol administration and video lottery terminal play among probable pathological gamblers and nonpathological gamblers.

The authors examined heart-rate responses to alcohol consumption and video lottery terminal (VLT) play. Regular VLT players (30 probable pathological gamblers [PPGs]; 30 nonpathological gamblers [NPGs]) were randomized to an alcohol (mean postdrinking blood alcohol concentration = 0.056%) or placebo condition. Heart rate was recorded at pre- and postdrinking baselines and during VLT play. Consistent with an earlier study, alcohol-condition participants displayed elevated heart rates relative to placebo-condition participants only at postdrinking and VLT play. Moreover, alcohol-condition participants showed a greater heart rate increase to VLT play than did placebo-condition participants. However, PPGs were not more susceptible to alcohol- and/or VLT play-induced heart rate accelerations than were NPGs. Implications for gambling/alcohol-disorder comorbidity are discussed.

Health correlates of pathological gambling in a methadone maintenance clinic.

This study compared methadone maintenance patients with and without pathological gambling (n = 167). Participants completed a self-report survey assessing lifetime pathological gambling and past-2-month gambling behavior, and they completed the SF-12v2 Health Survey, a measure of current mental and physical health. In the sample, 52.7% were classified as lifetime pathological gamblers, and the majority of pathological gamblers were actively gambling within the past 2 months. Multivariate analysis of covariance revealed that methadone maintenance patients with pathological gambling had significantly poorer mental and physical health than methadone maintenance patients without pathological gambling. These results suggest that pathological gamblers receiving methadone maintenance may benefit from additional psychosocial services. In fact, most pathological gamblers in the sample expressed interest in gambling-related services. These results extend previous research in other populations that has found that pathological gamblers report poorer mental and physical health than nonpathological gamblers.

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.

Alcohol’s Effects on Video Lottery Terminal (VLT) Play Among Probable Pathological and Non-Pathological Gamblers

This study tested whether alcohol increases behaviors associated with video lottery terminal (VLT) play, particularly among probable pathological gamblers. Forty-four regular VLT players were designated either probable pathological gamblers or non-pathological gamblers on the basis of scores on the South Oaks Gambling Screen (SOGS); [Lesieur & Blume (1997). American Journal of Psychiatry, 144, 1184-1188] Gamblers from each SOGS category were randomly assigned to either a moderately intoxicating alcohol dose or a control beverage condition (n = 11 per cell in the 2 x 2 between-subjects design). Following beverage consumption and absorption, participants played a video poker VLT game for up to 30 minutes. Four behaviors were measured: "power-bets" (doubling bet after viewing only two cards of the five-card poker hand); total money spent; mean bet magnitude; and number of minutes played. Alcohol increased time spent playing and rate of power-bets, particular among the probable pathological gamblers. Post hoc analyses revealed that alcohol also influenced the proportion of losing hands played--increasing them among the probable pathological gamblers while decreasing them among the non-pathological gamblers. Clinical and policy implications of the findings are discussed.

Freqüência de jogo patológico entre farmacodependentes em tratamento

To investigate the frequency of pathological gambling among alcohol and other substance abusers who sought specialized treatment. Seventy-four outpatients from three different substance abuse treatment services were interviewed. The South Oaks Gambling Screen (SOGS) scale was used for the diagnosis of pathological gambling. The diagnosis of alcohol and other substances abuse was established according to the DSM-IV criteria and the Short Alcohol Dependence Data (SADD) scale. The Portuguese version of the Self-Report Questionnaire (SRQ) scale was used to detect psychiatric symptoms and the Center for Epidemiological Studies Depression Scale (CES-D) for depressive symptoms. Average scores obtained from the application of these scales were compared using the Student t-test. All subjects met the criteria for drug abuse, 61.6% met the alcohol dependence criteria, 60.3% for cocaine/crack, and 34.2% for cannabis. According to the SOGS scale, the majority of drug addicts (70.3%) were classified as social gamblers, 10.8% as problem gamblers and 18.9% as pathological gamblers. Psychiatric and depression symptoms were found in the sample. Pathological gambling patients showed more depression symptoms than non-pathological gambling patients. A high frequency of pathological gambling was found among the drug addicts interviewed. It is emphasized the importance of investigating pathological gambling among patients under treatment of drug abuse and to include strategies for the treatment of this disorder.

Psychophysiological and subjective responses of a community sample of video lottery gamblers in gambling venues and laboratory situations

Physiological and subjective arousal in lounge and laboratory conditions were explored using heart rate (HR), skin conductance (SCL) and subjective ratings for a community sample (N=30) of video lottery terminal gamblers (14 non-pathological gamblers [NPG] and 16 probable pathological gamblers [PPG]). For all participants, mean heart rates and ratings of subjective arousal were higher in the lounge situation, while SCL did not differ between locations. SCL increased over baseline when gambling in both situations. HR initially increased over baseline in the lounge situation only, but by the end of gambling HR increased in both situations. HR, SCL and subjective reports were moderately correlated between venues. No correlations were found between subjective and physiological measures of arousal.

Using item response theory to examine gambling attitudes and beliefs

The gambling attitudes and beliefs scale (GABS: Breen and Zuckerman, 1999) was designed to assess a latent affinity for gambling. Using methods based in item response theory we demonstrated how a reduced set of GABS items maintained their relative severity and discriminated similarly when used among non-problem gambling students selected to represent low levels of gambling behavior (n=487) and when used clinically among treatment seeking pathological gamblers (n=234). This stability increases confidence both in the construct measured by the GABS and in the ability to assess levels of gambling affinity across disparate ranges of gambling-problem severity. The GABS also demonstrated incremental validity in predicting increases in the frequency of gambling behavior among non-problem gambling students beyond that explained by an index of gambling-problem severity. Implications for assessment of gambling affinity across pathological and nonpathological gamblers are discussed.

Perceptions among pathological and nonpathological gamblers

This study evaluated the perceptions of individuals while gambling on a Video Lottery Terminal. The primary goal was to compare the frequency of erroneous perceptions and of gambling-related perceptions among pathological and nonproblem gamblers. The degree of conviction in these perceptions was also evaluated. Each participant was assessed by a clinical psychologist using the DSM-IV criteria. Results showed that, contrary to the first hypothesis, no significant differences emerged between problem and nonproblem gamblers on the percentage of erroneous perceptions. But, pathological gamblers verbalized significantly more gambling related perceptions and were more convinced in the truth of their perceptions than the nonproblem gamblers. The theoretical and clinical implications of these results are discussed in order to improve the effectiveness of treatment interventions for pathological gamblers.

Psychophysiological and Subjective Arousal during Gambling in Pathological and Non-pathological Video Lottery Gamblers

Two groups of video lottery gamblers (pathological N =30, and non-pathological N =34) were compared while they participated in gambling and gambling related tasks using subjective ratings of excitement, electromyographic activity (EMG), skin conductance level (SCL) and heart rate (HR). Although the groups experienced similar levels of increased physiological response the pathological gamblers reported greater levels of subjective excitement. It was concluded that the pathological and non-pathological gamblers might perceive their responses to gambling and gambling related situations differently.

Relationship between problem gambling and substance use in a methadone maintenance population

Few studies have examined the relationship between pathological gambling and substance abuse treatment outcome. This study assessed the gambling behavior of 62 patients enrolled in a methadone maintenance treatment program. Eleven (17.7%) met current SOGS criteria for probable pathological gambling. Patients with and without probable pathological gambling were compared on substance abuse treatment outcome measures including urine toxicology results for heroin and cocaine use, and clinic dropout. Results indicated that those who were probable pathological gamblers were more likely to use cocaine through therapy, and more likely to drop out of the clinic treatment program than non-pathological gamblers. Implications for substance abuse treatment are discussed.

Using the Rasch model to evaluate the South Oaks Gambling Screen for use with nonpathological gamblers

Despite its utility for the dichotomous differentiation of pathological and nonpathological gamblers, some have questioned the use of the South Oaks Gambling Screen (SOGS) [Am. J. Psychiatry 144 (1987) 1184.] for discriminating individuals across the entire range of gambling problems. Using methods from item response theory, we derived a six-item version of the SOGS. This shortened version of the SOGS performed uniformly across a sample of pathological gamblers and a sample of students and resulted in five levels of discrimination and the following interpretation: a score of 1 reveals potential for problems; 2 reveals likely problem gambling; 3 or 4 items endorsed represent significant levels of problems noticeable by others; while 5 or 6 represents severe problems with significant financial involvement. We discuss the implications and remaining limitations of using this shortened measure for the continuum-based assessment of gambling problems.