Association between posttreatment gambling behavior and harm in pathological gamblers.

This study investigated the relationship between posttreatment gambling behavior and harm in a sample of treatment-seeking pathological gamblers. One year after initiating treatment, participants (n = 178) completed the Gambling Timeline Followback (D. C. Hodgins & K. Makarchuk, 2003; J. Weinstock, J. P. Whelan, & A. W. Meyers, 2004) and the South Oaks Gambling Screen (SOGS; H. R. Lesieur & S. B. Blume, 1987), both of which assessed gambling behaviors and problems over the prior 6 months. Based upon self-reports of gambling-related problems on the SOGS, participants were classified as problem free (SOGS scores = 0) or symptomatic gamblers (SOGS scores ≥ 1). Receiver operator characteristic curves evaluated classification by gambling behaviors for individuals classified in these 2 groups. Behavioral indicators for problem-free gambling were gambling no more than once per month, gambling for no more than 1.5 hr per month, and spending no more than 1.9% of monthly income on gambling. Alternative behavioral indicators were examined along a continuum of harm (SOGS cut-points of 1-5). These results provide preliminary data regarding intensity of gambling behavior associated with problem-free to probable pathological gambling in gamblers who presented for treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Gambling, gambling activities, and problem gambling.

This research examined similarities and differences between gambling activities, with a particular focus on differences in gambling frequency and rates of problem gambling. The data were from population-based surveys conducted in Canada between 2001 and 2005. Adult respondents completed various versions of the Canadian Problem Gambling Index (CPGI), including the Problem Gambling Severity Index (PGSI). A factor analysis of the frequency with which different gambling activities were played documented the existence of two clear underlying factors. One factor was comprised of Internet gambling and betting on sports and horse races, and the other factor was comprised of lotteries, raffles, slots/Video Lottery Terminals (VLTs), and bingo. Factor one respondents were largely men; factor two respondents were more likely to be women and scored significantly lower on a measure of problem gambling. Additional analyses indicated that (1) frequency of play was significantly and positively related to problem gambling scores for all activities except raffles, (2) the relationship between problem gambling scores and frequency of play was particularly pronounced for slots/VLTs, (3) problem gambling scores were associated with playing a larger number of games, and (4) Internet and sports gambling had the highest conversion rates (proportion who have tried an activity who frequently play that activity). (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

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. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

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. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Subtyping pathological gamblers based on impulsivity, depression, and anxiety.

This study examined putative subtypes of pathological gamblers (PGs) based on the Pathways model, and it also evaluated whether the subtypes would benefit differentially from treatment. Treatment-seeking PGs (N = 229) were categorized into Pathways subtypes based on scores from questionnaires assessing anxiety, depression, and impulsivity. The Addiction Severity Index—Gambling assessed severity of gambling problems at baseline, posttreatment, and 12-month follow-up. Compared with behaviorally conditioned (BC) gamblers, emotionally vulnerable (EV) gamblers had higher psychiatric and gambling severity, and were more likely to have a parent with a psychiatric history. Antisocial impulsive (AI) gamblers also had elevated gambling and psychiatric severity relative to BC gamblers. They were more likely to have antisocial personality disorder and had the highest legal and family/social severity scores. They were also most likely to have a history of substance abuse treatment, history of inpatient psychiatric treatment, and a parent with a substance use or gambling problem. AI and EV gamblers experienced greater gambling severity throughout treatment than BC gamblers, but all three subtypes demonstrated similar patterns of treatment response. Thus, the three Pathways subtypes differ on some baseline characteristics, but subtyping did not predict treatment outcomes beyond a simple association with problem gambling severity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Self-Reported Gambling-Related Suicidality Among Gambling Helpline Callers.

Problem gamblers often attribute suicidal ideation or attempts to their gambling. Logistic regression analyses were applied to data from problem gamblers (N = 986) calling a helpline. Problem gamblers reporting gambling-related suicidality (n = 252; 25.6%) were more likely than those denying it (n = 734; 74.4%) to acknowledge family, financial, legal, and mental and substance-related problems. Of problem gamblers acknowledging gambling-related suicidality, those reporting gambling-related suicide attempts (n = 53; 21.5%) were more likely than those denying them (n = 193; 78.5%) to acknowledge gambling-related illegal behaviors, mental health and substance abuse treatment, and family histories of alcohol problems, and were less likely to report prior gambling treatment. The findings suggest that increased gambling severity is associated with gambling-related suicidality. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

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 (J. E. Ware, M. Kosinski, & S. D. Keller, 1996), 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. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Suicide and gambling: Psychopathology and treatment-seeking.

The aim of this study was to evaluate suicides with a history of problem gambling (PG) and others with no such history (NPG) and to compare the two on mental health problems and service utilization. Data on a sample of 49 PG suicides and 73 NPG suicides were obtained from informants and hospital records. Psychopathology was prevalent in both groups, but problem gamblers were twice as likely to have a personality disorder. Moreover, PG suicides were less in contact with mental health services in their last month, their last year, and their lifetime. NPG suicides consulted specialized services from 3 (last month and last year) to 13 times (lifetime) as often as their PG counterparts. Lower service utilization associated with PG suicides argues in favor of stepping up detection, engagement in care and treatment with respect to problem gambling, especially when comorbidity is present. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Pathological gambling subtypes.

Although pathological gambling (PG) is regarded in the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 1994) as a unitary diagnostic construct, it is likely composed of distinct subtypes. In the current report, the authors used cluster analyses of personality traits with a non-treatment-seeking community sample of gamblers and identified 3 PG subtypes. Gamblers partitioned into a simple PG cluster, characterized by low rates of comorbid psychopathology and trait scores near the normative mean; a hedonic PG cluster, characterized by moderate rates of comorbid psychopathology and a proclivity for excitement seeking and positive affect; and a demoralized PG cluster, characterized by high rates of comorbid psychopathology and a propensity toward negative affect, low positive emotionality, and disinhibition. The findings provide preliminary support for an empirically based typology of gamblers, distinguishable in terms of personality structure, which may reflect different etiologies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Gambling cognition and subjective well-being as mediators between perceived stress and problem gambling: A cross-cultural study on White and Chinese problem gamblers.

This study aimed to delineate various pathways whereby cognitive and emotional vulnerabilities triggered by stress would lead to disruptive gambling. A multiple mediation framework was proposed to specify that gambling cognition and subjective well-being would mediate the influence of perceived stress on problem gambling. The cross-cultural validity of the proposed framework was examined with 132 White gamblers in Australia and 154 Chinese gamblers in China. They completed psychological scales on perceived stress, gambling expectancy bias, gambling refusal efficacy, negative affect, life satisfaction, and problem gambling. Compared to Chinese gamblers, White gamblers reported higher levels of perceived stress, gambling expectancy bias, and problem gambling as well as more pervasive negative affect and lower levels of life satisfaction. Results showed that the proposed multiple mediation framework fit the data better than two alternative plausible models. Life satisfaction and gambling refusal efficacy were two consistent mediators across White and Chinese gamblers. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Memory for future gambling wins.

Analogous to false memories for the past, gambling behavior may be influenced by the development of vivid, believed false “memories” for future gambling outcomes. We examined the degree to which believed memory-like representations for future gambling wins and losses were associated with prior substantial win experiences, frequency of gambling, risk for problem gambling, and other types of gambling expectancies. Regular gamblers with and without prior substantial wins rated the strength of a specific outcome expectancy, their belief that substantial gambling wins and losses would occur in the future, and rated the strength of “memory” for future gambling wins and losses. They then described a future win and a future loss and rated memory-like phenomenal characteristics for these events. Prior winners rated future wins as more believable relative to future losses, and rated future gambling outcomes as more memory-like than did gamblers without prior win experiences. Belief and memory for future wins correlated positively with frequency of gambling and positive response expectancies (e.g. relaxation when gambling). Belief and memory for future losses correlated with negative outcome expectancies and endorsement of problem gambling risk. Expecations about future wins and losses are likely influenced by believed memory-like representations for future wins and losses. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Pathological gamblers discount probabilistic rewards less steeply than matched controls.

Nineteen treatment-seeking men meeting Diagnostic and Statistical Manual for Mental Disorders (4th ed.) criteria for pathological gambling and 19 demographically matched controls participated. Participants provided demographic information, information about their recent drug use and gambling activities, and biological samples (to confirm drug abstinence). They also completed the Eysenck Personality Questionnaire, the South Oaks Gambling Screen (SOGS), and 2 questionnaires designed to separately quantify probability and delay discounting. Pathological gamblers discounted probabilistic rewards significantly less steeply than matched controls. A significant correlation revealed that more shallow probability discounting was associated with higher SOGS scores. Across groups, there was no significant difference in delay discounting, although this difference approached significance when education and ethnicity were included as covariates. These findings, collected for the 1st time with pathological gamblers, are consistent with previous reports that problem-gambling college students discount probabilistic rewards less steeply than controls. The nature of the relation between probability discounting and severity of problem gambling is deserving of further study. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

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. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Beliefs about control over gambling among young people, and their relation to problem gambling.

The aim of this study was to assess the association between beliefs about 2 types of control—(a) illusion of control and (b) internal locus of control—and gambling frequency–problem gambling among young people age 14 to 25 years (435 males, 577 females, and 5 unreported gender). A revised version of the South Oaks Gambling Screen and measures of gambling frequency and gambling beliefs were administered. Results indicated that irrational control beliefs were strongly associated with problem gambling. Young problem gamblers were more likely to believe that they needed money and that gambling would provide it. In addition, young problem gamblers had more faith in their ability to manipulate chance and "beat the system." Regression models with illusion of control and internal control over gambling significantly predicted gambling frequency and problem gambling. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Trusting problem gamblers: Reliability and validity of self-reported gambling behavior.

The retest reliability and validity of self-reported gambling behavior were assessed in 2 samples of problem gamblers. Days gambled and money spent gambling over a 6-month timeframe were reliable over a 2- to 3-week retest period using the timeline follow-back interview procedure (N=35; intraclass correlation coefficients [ICCs] ranged from .61 to .98). Gamblers did, however, report significantly more gambling at the 2nd interview. Agreement with collaterals was fair to good overall (ICCs ranged from .46 to .65) with no clear pattern of either over- or underreporting by gamblers. Spouses did not show greater agreement with gamblers compared with nonspouses, and greater agreement was not found for collaterals who were more versus less confident in their reports. The results are generally supportive of the use of self-reported gambling in studies of problem gamblers, assessed face to face and by telephone, although suggestions for further research are provided. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Impulsivity, life stress, refusal efficacy, and problem gambling among Chinese: Testing the diathesis-stress-coping model.

This study extended the diathesis-stress-coping model (Lazarus & Folkman, 1984) to understand problem gambling in Chinese societies. We examined core model components of impulsivity trait (diathesis), life stress, and gambling refusal efficacy (coping efficacy) with 942 Chinese college students and 153 Chinese gamblers. Results showed that the three core model components exerted main effects on problem gambling for both samples. Among college students, refusal efficacy interacted with impulsivity to influence problem gambling in male and female students, and interacted with life stress in male students only. In particular, more severe problem gambling was associated with higher impulsivity in low- but not high-efficacy students, and with higher stress in low- but not high-efficacy male students. Among gamblers, impulsivity interacted with life stress to influence problem gambling. In the high stress condition, high- relative to low-impulsivity gamblers reported more severe problem gambling, but this pattern was not found in the low-stress condition. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

A randomized trial of brief interventions for problem and pathological gamblers.

Limited research exists regarding methods for reducing problem gambling. Problem gamblers (N = 180) were randomly assigned to assessment only control, 10 min of brief advice, 1 session of motivational enhancement therapy (MET), or 1 session of MET plus 3 sessions of cognitive-behavioral therapy. Gambling was assessed at baseline, at 6 weeks, and at a 9-month follow-up. Relative to assessment only, brief advice was the only condition that significantly decreased gambling between baseline and Week 6, and it was associated with clinically significant reductions in gambling at Month 9. Between Week 6 and Month 9, MET plus cognitive-behavioral therapy evidenced significantly reduced gambling on 1 index compared with the control condition. These results suggest the efficacy of a very brief intervention for reduction of gambling among problem and pathological gamblers who are not actively seeking gambling treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Brief report: Exaggerated ethanol-induced cardiac reactivity as an indicator of increased risk for gambling.

Pathological gambling and alcohol dependence show a high rate of co-occurrence. Some individuals at risk for alcohol dependence display an exaggerated heart rate (HR) increase following alcohol consumption, a characteristic suggesting sensitivity to reward. This study examined whether exaggerated ethanol-induced cardiac reactivity was associated with increased gambling behaviors. One hundred five young men (M = 20.13 years, SD = 1.07) consumed 1 ml of ethanol (95% volume) per kilogram of body weight. HR was measured and participants completed the South Oaks Gambling Screen (SOGS; H. R. Lesieur & S. B. Blume, 1987). Those with higher intoxicated HRs reported significantly greater scores on the SOGS (p = .02). This suggests that ethanol-induced HR increase is a possible marker for addictive disorders. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Concordance between the SOGS-RA and the DSM-IV criteria for pathological gambling among youth.

This study assessed the possible differences in the classification of adolescent gamblers when using the South Oaks Gambling Screen-Revised for Adolescents (SOGS-RA; K. C. Winters, R. D. Stinchfield, & J. Fulkerson, 1993) versus a clinical interview that was based on Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric Association, 1994) criteria for pathological gambling. A total of 631 adolescents ages 15-17 years participated in the two phases of the study. Results revealed that of the 93 adolescents who had been screened as problem gamblers according to the SOGS-RA, only 7 could be clinically confirmed as pathological gamblers according to the criteria used at present to define pathological gambling. The need to clarify the construct of pathological gambling among youth is discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive changes in pathological gamblers following a 28-day inpatient program.

A cognitive explanation for pathological gambling (PG) posits that problem gambling behaviors are maintained by irrational beliefs and attitudes about gambling. However, it has never been shown that beliefs and attitudes about gambling are affected by treatment. This exploratory study examined the effect of a 28-day inpatient treatment program on beliefs and attitudes in pathological gamblers (PGs). The participants were 66 consecutive admissions to a Veterans Affairs inpatient program for PG. Participants completed a self-report measure of gambling-specific attitudes and beliefs at admission and again before discharge. Discharge scores indicated significant change (p ?