Rates Of Pathological Gambling Research Articles

A systematic review of gambling-related findings from the National Epidemiologic Survey on Alcohol and Related Conditions.

Background and aimsThis systematic review analyzes and summarizes gambling-related findings from the nationally representative US National Epidemiological Survey on Alcohol and Related Conditions (NESARC) data.MethodsSystematic literature searches in accordance with PRISMA guidelines found 51 eligible studies that met inclusion criteria. Eight studies utilized both Waves 1 and 2 NESARC data, and selection of sample sizes varied from 185 to 43,093 individuals, consistent with specified research objectives of each study.ResultsThe prevalence of lifetime pathological gambling was 0.42% (0.64% among men, 0.23% among women), while past-year prevalence was 0.16%. Pathological gambling rates were generally higher in populations with substance-use disorders and other psychiatric diagnoses. Rates of adverse childhood experiences and suicidal attempts were higher among individuals with problem or pathological gambling. Early-onset gamblers were more likely to be male, be never married, have incomes below $70,000, belong to younger cohorts and have Cluster B personality disorders, but less likely to be diagnosed with mood disorders. While pathological gambling was related to obesity, increased stress, and poorer physical health among general age groups, recreational gambling was linked with improved physical and mental functioning in older adults.ConclusionsThe NESARC has provided important information on the correlates of pathological gambling and subdiagnostic patterns of gambling behaviors. Additional studies should examine these relationships in the current gambling environment and longitudinally with aims of implementing policies to improve the public health.

A Meta-analytical Synthesis and Examination of Pathological and Problem Gambling Rates and Associated Moderators Among College Students, 1987-2016.

The problem of gambling addiction is especially noteworthy among college students, many of whom have the resources, proximity, free time, and desire to become involved in the myriad options of gambling now available. Although limited attention has been paid specifically to college student gambling in the body of literature, there have been three published meta-analyses estimating the prevalence of probable pathological gambling among college students. The research presented is the largest and most comprehensive, presenting an up-to-date proportion of those students worldwide exhibiting gambling pathology as assessed by the South Oaks Gambling Screen, and is the first to include estimates of sub-clinical problem gambling. A thorough literature review and coding procedure resulted in 124 independent data estimates retrieved from 72 studies conducted between 1987 and the present, surveying 41,989 university students worldwide. The estimated proportion of probable pathological gamblers among students was computed at 6.13%, while the rate of problem gambling was computed at 10.23%. Statistical significance was found in the influence of the percentage of non-white students on pathological gambling rates. The implications of this and other moderator analyses such as age and year of studies, as well as recommendations for future practice in dealing with college students and gambling disorder on campus are outlined and described in detail. Suggestions and rationales for future avenues of research in the area are also described.

A study of pathological gambling and its correlates among patients seeking treatment for substance use disorders in North India

ABSTRACTBackground: Gambling, although being a common leisure activity in India, and it has been studied scarcely. There is a dearth of research regarding the rates of problem gambling among substance users in India. Methods: This cross-sectional observational study was conducted at a tertiary care de-addiction center in India. Male patients aged 18–65 years were included. Diagnosis of gambling disorder or pathological gambling were made using Diagnostic and Statistical Manual–Fifth edition (DSM-5) and International Classification of Disorders–10th Edition Diagnostic Criteria for Research (ICD-10 DCR) respectively. Pattern of gambling as well as the prevalence of probable pathological gambling was assessed using South Oaks Gambling Screen (SOGS). Results: A total of 114 substance users were recruited in the study. The occurrence rate of pathological gambling according to ICD-10 DCR was 6.1%, gambling disorder according to DSM-5 was 11.4%, and probable pathological gambling according to SOGS was 12.3%. Playing cards for money was the most common type of gambling. Pathological gamblers had higher rates of injection drug use and high-risk sexual behaviors as compared to non-problem gamblers. Conclusion: Our study suggests pathological gambling to be a common comorbidity among substance use disorder patients. There is a need to study the impact and course of pathological gambling among the Indian patients with substance use disorders.

Gambling behind the walls: A behavior-analytic perspective.

The field of behavior analysis has done an excellent job of not only raising public awareness about certain disorders (e.g., Autism), but also developing the best treatments for those disorders. The field has not yet, however, done so for many behavioral disorders. For instance, pathological gambling is a major societal issue, but little behavior-analytic work has focused on it despite the fact that the disorder occurs at several times the frequency of other, more publicized, disorders such as Autism (Dixon, Marley, & Jacobs, 2003). One possible reason for the dearth of behavior-analytic research could be B.F. Skinner's (1953) conclusion that gambling behavior could be understood in terms of schedules of reinforcement. Subsequent research, however, suggests that multiple factors likely control gambling behavior (e.g., see Weatherly & Dixon, 2007). According to most prevalence studies, the rate of pathological gambling in the general population likely ranges between 1 -2% (see Petry, 2005, for a review). In terms of absolute numbers, these percentages represent millions of individuals in the United States alone. The numbers do not, however, encapsulate the problem. That is, pathological are individuals who officially meet diagnostic criteria according to the DSM-IV-TR (American Psychiatric Association, 2000). Other people are labeled as gamblers because they display some symptoms of pathological gambling, but not enough symptoms to be diagnosed clinically as pathological. The prevalence rates of problem gambling are also difficult to estimate, but it seems reasonable to conclude that the number of problem exceeds the number of pathological gamblers, possibly another 5% or more of the population (see Petry, 2005). Pathological gambling is currently classified as an impulse disorder that is not otherwise classified. (1) To meet diagnostic criteria for pathological gambling, an individual must display at least five of the ten possible symptoms. Three of these symptoms are generally considered in nature. The possible cognitive symptoms include a preoccupation with gambling, feeling the need to increase one's betting so as to maintain the original level of excitement or arousal, and feeling restless when one attempts to cease gambling. (2) Six of the remaining seven symptoms are descriptive of behaviors in which the gambler might engage. They are trying to cease gambling but failing, increasing one's betting in an attempt to win back what has been lost (i.e., chasing one's bet), lying to others so as to conceal one's gambling, engaging in illegal behavior to finance one's gambling, putting one's opportunities (e.g., job, personal relationships, etc.) in jeopardy because of continued gambling, and turning to other individuals to finance one's gambling or to address financial issues that have resulted from one's gambling. (3) Interestingly, only one of the official symptoms for pathological gambling specifically identifies a contingency that might be controlling the person's gambling behavior; that the person gambles as an escape. It will therefore likely come as no surprise to behavior analysts that this particular symptom may have special relevance, which will be addressed later in the paper. As one might imagine, the research literature on gambling is immense (and beyond the scope of the present paper to review all of it), and many researchers have attempted to identify the factors that lead to pathological gambling. Unfortunately, the vast majority of this research is correlational in nature. As such, associative relationships can be, and have been, identified. However, the causal mechanisms underlying the disorder have not been firmly established. Regardless, research has potentially identified the establishing operations (Michael, 1993) or setting events (Kantor & Smith, 1975) for pathological gambling. As outlined by Petry (2005), there are six major risk factors for pathological gambling, several of which may be intercorrelated. …

Pathological and disordered gambling: a comparison of DSM-IV and DSM-V criteria

The proposed revision of the diagnostic criteria for pathological gambling within the DSM suggests removing the criterion of committing illegal acts and reducing the threshold to four symptoms. It has been argued that changing the diagnostic criteria will not impact the prevalence rate of pathological gambling, however there are no published studies examining prevalence rate stability. The impact of the proposed DSM-V criteria using data from a national study assessing gambling behaviors among college student-athletes was examined. Comparison of pathological or disordered gamblers vs sub-threshold gambling severity using current DSM-IV criteria and the proposed DSM-V diagnostic criteria suggests that the proportion of men classified as pathological or disordered gamblers changes. For females, comparisons did not reach statistical significance. The subcommittee of the DSM-V should note that the proportion of males meeting the diagnostic criteria for pathological gambling may be influenced by classification system. Questions related to the validity of the proposed classification system are raised.

Jeu pathologique : facteurs impliqués

In France, consumption of gambling games increased by 148% between 1960 and 2005. In 2004, gamblers lost approximately 0.9% of household income, compared to 0.4% in 1960. This represents approximately 134 Euros per year and per head. In spite of this important increase, the level remains lower than the European average (1%). However, gambling practices may continue to escalate in France in the next few years, particularly with the recent announce of the legalisation of online games and sports betting. With the spread of legalised gambling, pathological gambling rates may increase in France in the next years, in response to more widely available and more attractive gambling opportunities. In this context, there is a need for better understanding of the risk factors that are implicated in the development and maintenance of pathological gambling. This paper briefly describes the major risk factors for pathological gambling by examining the recent published literature available during the first quarter of 2008. This documentary basis was collected by Inserm for the collective expert report procedure on Gambling (contexts and addictions). Seventy-two articles focusing on risk factors for pathological gambling were considered in this review. Only 47 of them were taken into account for analysis. The selection of these 47 publications was based on the guide on literature analysis established by the French National Agency for Accreditation and Assessment in Health (ANAES, 2000). Some publications from more recent literature have also been added, mostly about Internet gambling. We identify three major types of risk factors implicated in gambling problems: some of them are related to the subject (individual factors), others are related to the object of the addiction, here the gambling activity by itself (structural factors), and the last are related to environment (contextual or situational factors). Thus, the development and maintenance of pathological gambling seems to be conditioned by the interaction of a person and a gambling activity, in a particular context. This conceptual model is based on the well-known theory of Olivenstein on toxicomania, which was proposed in the seventies. The structural factors that appeared to be highly related to pathological gambling development and maintenance are payment modality, entertaining dimension, temporality, reward level, educational messages, gambling ambiance, gambling medium and part of hazard. Among contextual factors, availability and accessibility of gambling opportunities are well known. However, social and economic factors (e.g. culture, ethnicity, religion, education) are also important. Lastly, among individual factors, psychosocial factors are gender, age, familial and personal antecedents and psychiatric comorbidities. Neurobiological factors are not discussed here. This paper briefly summarises risk factors for development and maintenance of pathological gambling. It highlights that these factors are very similar to those that are implicated in substance use disorders, except for the gambling activity and context. Prevention regarding behavioural addictions should, in the future, take advantage of the findings on substance use disorder, since behavioural addictions are less known. Conversely, it seems obvious that findings on pathological gambling, and more widely behavioural addictions, could highlight all types of addiction. It appears that this fact is especially valid with regards to the evolution and stability of addictive status, which must be taken into account for treatment proposals.

Psychopharmacological Treatment in Pathological Gambling: A Critical Review

Given the rates of pathological gambling and its impact on affected individuals and their relatives, effective treatments are needed. There are, however, no approved pharmacological treatments for pathological gambling. This paper describes the development of pharmacological treatments for pathological gambling and is based on a review of the literature published in the past 10 years. Important studies were carried-out on antidepressants, mood stabilizers, and antipsychotic agents. In the absence of comorbid psychiatric disorder, these studies did not conclude to the efficacy of these psychotropic drugs. A possible efficacy of opiate antagonist treatment for pathological gambling has been replicated in a number of placebo-controlled studies. Preliminary results on N-acetyl cysteine, Memantine and Topiramate produced significant improvement for pathological gamblers and may open new avenues for treatment.

Evaluation of a Shortened South Oaks Gambling Screen in veterans with addictions.

Rates of pathological gambling have increased with the availability of legalized gambling. Substance-abuse units increasingly recognize the need to assess for gambling problems. The South Oaks Gambling Screen (SOGS; H. R. Lesieur & S. B. Blume, 1987) has filled this need. Previous research (M. Oehlert & K. Nelson, 2004) has considered the feasibility of reducing the length of the SOGS while maintaining its ability to identify people at risk for problematic gambling. In this study, the authors examined the utility of a shortened SOGS (SSOGS) in a 2nd sample of veterans with addictions. The authors used data analysis to explore SSOGS psychometric properties and to provide additional support for use of the shorter instrument.

Prevalence of pathological gambling in Switzerland: A replication study

This survey aimed to evaluate the prevalence of pathological gambling in the Swiss adult population in 2005 and the link between pathological gambling and alcohol abuse. This replication study made it possible to compare the prevalence rates of pathological gambling measured before and after the introduction of casinos and new preventive legislation in Switzerland.Method:Two thousand eight hundred and three telephone interviews were completed using a standardized assessment instrument for identifying problem and pathological gamblers (SOGS) and alcohol abuse (CAGE).Results:In Switzerland, the past year prevalence rates were 0.8% for problem gambling and 0.5% for pathological gambling in 2005. No relationship was found between alcohol abuse and gambling behaviour. The past-year prevalence of problem and pathological gambling did not change between 1998 and 2005.When comparing the percentage of “ problem gamblers” (levels 2 + 3) who probably have an alcohol problem found in 1998 with that found in 2005, results show a statistically significant difference [χ2=4.1; p<.05]. This important change may be related to the fact that slot machines were then present in public bars where alcohol was more readily available, without the controls of the preventive measures implemented in all Swiss casinos after 2002.Conclusions:Despite widespread openings of casinos in Switzerland since 2002, the prevalence estimates of past-year disordered gambling have remained stable.

Schizophrenia and Pathological Gambling

High rates of pathological gambling are found in psychiatric populations, including those with mood or substance use disorders. The extent to which individuals with schizophrenia exhibit the symptoms of pathological gambling has not been adequately investigated. This paper examines the case of a 40-year-old schizophrenic female with a four-year history of gambling. The characteristics of possible interactions between pathological gambling and schizophrenic symptom profiles are outlined in order to propose better treatments for this group of patients.

A Prospective Study of the Impact of Opening a Casino on Gambling Behaviours: 2- and 4-Year Follow-ups

It is widely believed that the rate of pathological gambling is related to the accessibility and availability of gambling activities. Few empirical studies have yet been conducted to evaluate this hypothesis. Using a longitudinal prospective design, the current study evaluates the impact of a casino in Canada's Hull, Quebec region. A random sample of respondents from Hull (experimental group) and from Quebec City (comparison group) completed the South Oaks Gambling Screen (SOGS) and gambling- related questions before the opening of the Hull Casino (pretest), 1 year after the opening (posttest), and on follow-up at Years 2 and 4. Although, 1 year after the opening of the casino, we did observe an increase in playing casino games and in the maximum amount of money lost in 1 day's gambling, this trend was not maintained over time (2- and 4-year follow-ups). In the Hull cohort, the rate of at-risk and probable pathological gamblers and the number of criteria on the SOGS did not increase at the 2- and 4-year follow-ups. The residents' reluctance to open a local casino was generally stable over time following the casino's opening. The discussion raises different explanatory factors and focuses on the context of the Regional Exposure Model as a potentially more applicable measure of studying the expansion of gambling.

DSM-IV-J criteria: a scoring error that may be modifying the estimates of pathological gambling among youths.

Previous studies have shown that prevalence rates among youths may be inflated due to a problem in understanding the questions of the SOGS-RA and DSM-IV-MR-J. This article reports another reason why prevalence rates of pathological gambling among youths may be inflated. In 1992, Fisher proposed 9 criteria (the DSM-IV-J) for diagnosing pathological gambling among youths, and formulated 12 questions (the Test questions) to identify the presence of these criteria. An analysis of a sample of studies using the DSM-IV-J reveals that some researchers have incorrectly used the 12 Test questions instead of the 9 criteria, which may have led to overestimated prevalence rates among youths. Other measurement issues may also be contributing to the overestimation of problem gambling in young people. The methodological implications of these issues are discussed.

Gambling participation in the U.S.--results from a national survey.

Demographic patterns of gambling participation in the U.S. were examined. A national telephone survey was conducted with 2,630 representative U.S. residents aged 18 or older. The sample as weighted for analysis was 48% male, 12% black, and 11% Hispanic. Respondents were questioned on 15 types of gambling: how often they played and how much they won or lost. Eighty-two percent gambled in the past year. Lottery was the most commonly played game, while casino gambling accounted for the largest extent of gambling involvement. Men and women were equally likely to gamble in the past year, but men gambled more frequently and had larger wins and losses, particularly on sports betting and games of skill. Blacks were less likely to have gambled in the past year, but blacks who gambled did so more heavily than other racial groups. Blacks and Hispanics were more likely than average to be pathological gamblers. The rate of past year gambling declined with age, but extent of gambling involvement among gamblers did not vary with age. Rates of participation in most forms of gambling increased with socioeconomic status, but higher socioeconomic status gamblers had lower rates of pathological gambling, and lower extent of gambling involvement, particularly for lottery. New Englanders gambled more heavily than other Americans. Comparison with past studies showed an increase in overall gambling participation in the U.S., and large increases in rates of participation in lottery and casino gambling.

Perceptions of the extent of problem gambling within new casino communities.

Several recent studies using objective measures have found that the rate of pathological gambling in the U.S. is less than 5%. To determine the general population's perception of the prevalence of pathological gambling, a survey was conducted in seven communities where casinos have recently opened. Of the 1631 respondents who provided an estimate, the mean response was that 16% of the community residents were problem gamblers, more than three times the rate found by studies using specific diagnostic criteria. A regression equation found several demographic and attitudinal items are associated with higher prevalence estimates. In addition, the data support a "close to home" hypothesis that respondents who have relatives who have experienced problems with gambling will tend to perceive higher rates of problem gambling in the community.

Problem gambling and comorbid psychiatric and substance use disorders among drug users recruited from drug treatment and community settings.

Little is known about gambling rates of drug users recruited from drug treatment compared with those recruited from the community. We use the Diagnostic Interview Schedule (DIS) to provide lifetime prevalence estimates of problem gambling (i.e., at least one gambling problem) and DSM-III-R pathological gambling (i.e., at least four gambling problems) and describe the association between gambling and psychiatric disorders for drug users recruited from drug treatment settings (n = 512) and from the community (n = 478). We also report the relative risk of being a recreational and problem gambler in this sample. The sample was first interviewed in 1989-90 as a part of two NIDA-funded St. Louis-based studies. The prevalence of problem gambling in the overall sample was 22% and the prevalence of pathological gambling was 11%. There were no statistically significant differences in problem and pathological gambling rates for subjects recruited from drug treatment and those recruited from the community. The conditional prevalence rates, that is, the rate of problem and pathological gambling only among gamblers were 27% and 13.5%, respectively. Major findings indicate that problem gambling was associated with Antisocial Personality Disorder (ASPD), even after controlling for recruitment source and socio-demographic characteristics. In fact, when examining the temporal order of these disorders, we found that pathological gambling was always secondary to ASPD, occurring on average 11.4 years after the onset of ASPD. Problem gamblers, compared with everyone else, were more likely to be male, African-American, recruited from drug treatment, have ASPD and be dependent on illicit drugs. Multinomial logistic regression analysis predicted the relative risk of being a recreational and problem gambler (compared with a nongambler) in this sample according to socio-demographics, ASPD, and dependence on illicit drugs. Results imply that screening for gambling problems will need to be broad-based among drug users.

Adolescent Gambling Behavior: A Prevalence Study and Examination of the Correlates Associated with Problem Gambling.

Eight-hundred and seventeen adolescent high school students in the Montreal region completed the DSM-IV-J gambling screen along with a questionnaire devised by the authors inquiring about their gambling behavior, including items assessing the types of activities in which they engage, frequency of involvement, reasons for gambling, and their cognitive perceptions of gambling activities. The results indicate that, in general, 80.2% of students reported having gambled during the previous year, with 35.1% gambling a minimum of once per week. Adolescents reported participating in gambling behavior more often than any other addictive behavior, including cigarette smoking, alcohol consumption, and illicit drug use. The mean age of onset of gambling behavior for the sample was 11.5 years. The rate of pathological gambling was 4.7% as measured by the DSM-IV-J. Pathological gamblers were more likely to have parents with gambling problems and to be engaging in illegal activities than non-pathological gamblers. Gender differences were evident, with males engaging in gambling activities more than females. Differences in game preferences were found, with males more attracted to sports lottery tickets and sports pool betting and females more attracted to lottery tickets and bingo. Gambling awareness and prevention issues are addressed.

Problem Gambling Within a Chinese Speaking Community.

The purpose of this study was to obtain preliminary data on pathological gambling rates within a metropolitan Chinese community to determine if more costly extensive epidemiological surveys were justified. Two thousand survey questionnaires were distributed to parents through children attending a local Chinese speaking school. A response rate of 27.4% was obtained. Over a quarter of respondents were born overseas in either Mainland China or Hong Kong. Results indicated that gambling was not a popular activity with 60.0% of respondents stating that they never gambled. Of those who gambled, a third of respondents identified lotto as the preferred form. Using a Chinese translation version of the SOGS and a cut-off score of 10, a prevalence estimate of 2.9% for pathological gambling was found with males showing a higher rate (4.3%) as compared to females (1.6%). Respondents reporting a prior history of gambling in their country of origin were more likely to be classified as probable pathological gamblers. Despite the use of a sample of convenience, changes to the wording of two items in the Chinese translation of the SOGS and the possibility of false positive cases in the present study, it is concluded that further research into problem gambling in this community should be undertaken.

Rates of pathological gambling in publicly funded outpatient substance abuse treatment

Rates of problem or probable pathological gambling were assessed in substance abusers seeking outpatient treatment in a publicly funded outpatient substance abuse treatment program. The South Oaks Gambling Screen (SOGS) was administered to 467 consecutive admissions at three different sites. Problem gamblers comprised 6.2 percent of the total (n=29), and 4.5 percent scored as probable pathological gamblers (n=21). These rates are two and one-half times greater than would be expected according to a recent state survey using the SOGS. Implications for assessment and treatment of problem gambling are discussed.

Characteristics of Pathological Gamblers Identified Among Patients on a Psychiatric Admissions Service

A total of 105 patients admitted to a psychiatric admissions service for adults were screened for pathological gambling using the South Oaks Gambling Screen, a valid, reliable instrument for identification of this disorder. Seven of the 105 patients were identified as pathological gamblers, and ten were children of problem gamblers, rates that are higher than those for the general population. Pathological gamblers identified in this study had a broad range of primary diagnoses, including schizoaffective disorder, paranoid schizophrenia, major depression, and organic personality disorder. A high rate of pathological gambling (11 percent) was found among patients with a secondary diagnosis of psychoactive substance use disorders.

Pathological gambling: estimating prevalence and group characteristics.

A problem which lies in the path of implementing policies designed to address the adverse effects of gambling is the lack of data on the size and composition of the compulsive gambler group. There is a pressing need, therefore, to develop a data base on gambling participation and its consequences. The present study sought to contribute to this goal by identifying the rate of pathological gambling among adults residing in a nine-county area of southeastern Pennsylvania and southern New Jersey. The study was designed as a scientific community survey employing behavioral criteria as the basis for identification of pathological gamblers.