MEDLINE Abstracts: Gambling

February 04, 2003

MEDLINE Abstracts: Gambling

What's new concerning gambling? Find out in this easy-to-navigate collection of recent MEDLINE abstracts compiled by the editors at Medscape Psychiatry.

Barnes GM, Welte JW, Hoffman JH, Dintcheff BA
J Stud Alcohol. 2002;63:767-775

Objective: Gambling and alcohol misuse are prevalent among youth and may be part of a common problem behavior syndrome. It was hypothesized that alcohol misuse would predict a pattern of increased youth gambling or a pattern of stable high gambling after controlling for key sociodemographic, socialization and individual factors.
Method: Data were analyzed from two longitudinal studies of youth living in a western New York metropolitan area. Respondents' gambling at two times over the course of 12-18 months was classified into one of five gambling pattern groups, representing flat-low, increasing, flat-medium, flat-high and decreasing levels of gambling.
Results: Alcohol misuse among males predicted increasing gambling over time or a pattern of stability of high rates of gambling even after controlling for socioeconomic status, race, age, impulsivity and parental monitoring in the family study. Higher parental monitoring and lower alcohol misuse were significant in predicting a decreasing pattern of gambling among males in the male delinquency study. For females in the family study, alcohol misuse predicted an increasing pattern of gambling only when other factors such as high impulsivity or low parental monitoring were present.
Conclusions: An understanding of adolescent gambling must take into account a variety of demographic, socialization and individual factors, as well as the co-occurrence of alcohol misuse.

Neighbors C, Lostutter TW, Cronce JM, Larimer ME
J Gambl Stud. 2002;18:361-370

The present research combined qualitative and quantitative approaches in examining gambling motives among college student gamblers. A comprehensive set of 16 gambling motives was identified by categorizing 762 open-ended reasons for gambling, provided by 184 college student gamblers. Results revealed that most college students gamble to win money, for fun, for social reasons, for excitement, or just to have something to do. Overall, the results suggest the need for an eclectic biopsychosocial approach with regard to etiology of college student gambling.

Neighbors C, Lostutter TW, Larimer ME, Takushi RY
J Gambl Stud. 2002;18:339-360

The present research describes the proposal and validation of three gambling outcome measures, the Gambling Quantity and Perceived Norms Scale (GQPN), the Gambling Problem Index (GPI), and the Gambling Readiness to Change Questionnaire (GRTC). The study consisted of 560 undergraduate college students who completed a survey including the newly constructed measures and other measures designed to assess convergent validity. Results confirmed good reliability and convergent validity of all three measures. Implications for evaluating efficacy of treatment and prevention interventions are detailed.

Welte JW, Barnes GM, Wieczorek WF, Tidwell MC, Parker J
J Gambl Stud. 2002;18:313-337

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.

Stinchfield R
Am J Psychiatry. 2003;160:180-182

Objective: The purpose of this study was to measure the reliability, validity, and classification accuracy of the DSM-IV diagnostic criteria for pathological gambling.
Method: Participants in this study were drawn from two sources: 803 men and women from the general adult population of Minnesota and 259 men and women who were admitted to a gambling treatment program. A 19-item measure of the DSM-IV diagnostic criteria for pathological gambling was administered, along with other validity measures.
Results: The DSM-IV diagnostic criteria were found to be reliable and valid. With a standard cutoff score of 5, DSM-IV criteria yielded satisfactory classification accuracy results; however, a cutoff score of 4 made modest improvements in classification accuracy and, most important, reduced the rate of false negatives.
Conclusions: The DSM-IV diagnostic criteria for pathological gambling, when operationalized into questions, demonstrated satisfactory reliability, validity, and classification accuracy, and a cutoff score of 4 improved diagnostic precision.

Kaminer Y, Burleson JA, Jadamec A
Subst Abus. 2002;23:191-198

This study assessed the prevalence and correlates of gambling behavior (GB) in adolescent substance abusers (N = 97) consecutively admitted to an outpatient treatment program. Thirty-four percent of the cohort had never gambled; 57% were classified as social/nonpathological gamblers; 8% were labeled as in transition gamblers; and only 1% met criteria for pathological gambling. A significant finding was that males are more likely to gamble and to have a higher severity score than do females. A younger age of GB onset is seen for girls than boys and is correlated with a history of suicide attempts, diagnosis of depression, number of symptoms of oppositional behavior, cluster B personality disorders, and a higher need for psychiatric treatment. None of the gambling youths was ever referred for GB counseling. Increased awareness for and additional studies of adolescent gambling are required.

Martins SS, Lobo DS, Tavares H, Gentil V
Rev Hosp Clin Fac Med Sao Paulo. 2002;57:235-242

Pathological gambling was only recently recognized as a psychiatric disorder (DSM-III, APA, 1980). Most studies of pathological gambling include only male subjects. Despite the paucity of information, it is likely that at least one-third of pathological gamblers are women. The objective of this article is to review clinical and epidemiological characteristics of female gamblers as compared to their male counterparts. MEDLINE and PsycINFO were searched for investigational studies and reviews of the past 10 years on clinical (sociodemographic, course and progression, psychiatric comorbidities, genetics, and personality) and epidemiological aspects of female gamblers. Other relevant articles were also selected from reference lists. It is concluded that the current literature indicates some common characteristics in female and male gamblers, but it also indicates the possibility that each gender may carry etiopathogenic differences that when better understood should lead to improved treatment and prevention strategies.

Hodgins DC, Engel A
J Nerv Ment Dis. 2002;190:775-780

The hypothesis that pathological gambling is associated with shortened time horizons was investigated by administering the Zimbardo Time Perspective Inventory (ZTPI) and the Future Time Perspective Inventory (FPTI) to a group of pathological gamblers and two comparison groups, psychiatric day patients and social gamblers. The South Oaks Gambling Screen (SOGS) was used to assess the severity of the participants' gambling. Sixty-six participants were recruited, of which 35 were women. The mean age of participants was 39 years. Results showed significantly shorter time horizons in pathological versus social gamblers but few differences between pathological gamblers and psychiatric patients. These results suggest that shortened time horizons are not a unique feature of addicted populations. The role of psychological distress as a possible explanatory variable is discussed.

Robson E, Edwards J, Smith G, Colman I
J Gambl Stud. 2002;18:235-255

An implementation and one-year follow-up of the Gambling Decisions program attempted to answer several important questions. First, is controlled gambling a viable treatment option for some gamblers? Can earlier stage problem gamblers be separated for treatment from those with more severe problems? Finally, would problem gamblers utilize a community health agency for treatment of their excessive gambling? A pretest/posttest design was chosen where the efficacy of the program was assessed using repeated measures ANOVA analysis. Results showed that an average loss of $608 over a 4-week period was reduced to $113 immediately after the 6-week program and to a loss of $73 at 12 months. The average number of hours spent gambling per 4 weeks was significantly reduced from 23.5 at pretest to 6.5 at the 12 month posttest. Significant decreases were also observed in the number of days per week that clients gambled, and clients reported significant reductions in everyday life problems related to gambling after completing the program.

Raylu N, Oei TP
Clin Psychol Rev. 2002;22:1009-1061

Due to recent changes of gambling laws, accessibility to gambling has become more widespread and thus, there has also been an increase in the prevalence of pathological gambling (PG). The wide range of social, economic, and psychological problems associated with PG are well known. There is a need for better understanding of PG and this review attempts to do so. Literature searches using the Medline and PsycINFO databases were used. Critical examining of the literature showed that familial/genetic, sociological, and individual factors (e.g., an individual's personality, biochemistry, psychological states, and cognitions) are implicated in the development and maintenance of PG, yet at present, the evidences are not solid. Similarly, there have been a lot of theories for PG but again, none of them are solid enough to provide a clear understanding of PG. Recent psychological-based theories seem to provide some solid ground for further research. We highlight four areas for future consideration for research. (1) Most studies have generalized findings from one form of gambling to another. It is suggested that it is now not tenable to consider gambling as a single phenomenon that can explain all forms of gambling. (2) Almost all of the studies in the gambling literature are Western-based and the results are often generalized to other ethnic and cultural groups. There is now an urgent need to close this gap. (3) Future studies need to address methodological problems in the current gambling/PG literature. (4) Almost all of the gambling literature has focused on the issue of why people start gambling. It is suggested that looking at variables as to why people stop gambling in a single episode may be a more fruitful area of research then why people start gambling. This is because what motivates one to continue gambling, despite losses in a session and across sessions, is a characteristic that distinguishes nonproblem gamblers from problem gamblers and pathological gamblers (PGs).

Petry NM
Exp Clin Psychopharmacol. 2002;10:184-192

Substance use disorders and pathological gambling share similarities in terms of diagnostic criteria, epidemiology, and clinical course. However, relatively few studies have evaluated the efficacy of treatments for gambling disorders. As interest in pathological gambling grows, adaptation of effective treatments from the field of substance abuse may advance the study of treatment for pathological gambling. This article reviews the similarities and differences between pathological gambling and substance use disorders. It describes psychotherapeutic and pharmacological treatments for substance use disorders and their translation to pathological gambling. Future research should consider investigating the onset and course of pathological gambling within the context of other psychiatric disorders, biological abnormalities associated with gambling, and combined effects of psychotherapy and pharmacotherapy in the treatment of this disorder.


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