Département des Sciences de santé Communautaire, Service de Toxicomanie, Université de Sherbrooke, Campus de Longueuil, 1111, rue St-Charles Ouest, Tour Ouest, Bureau 500, Longueuil, QC, Canada J4K 5G4. karine.bertrand@usherbrooke.ca
The study of the effectiveness of treatment for pathological gambling constitutes a field that is still largely unexplored. To date, the models assessed primarily target the individual and include little or no involvement of the family circle. Yet, the deleterious effects of gambling on loved ones and especially spouses are well recognized. Further, the addition of a couple modality to individual treatment has been shown to be effective on many levels in the treatment of substances use disorders. This article therefore proposes a critical review of (1) the literature providing a better understanding of the complex interactions between the couple relationship and pathological gambling, (2) studies on the effects of couple therapies on gamblers and their partners. We then present the therapeutic model developed by our team of clinician-researchers in collaboration with actors from Québec clinical settings: Adapted Couple Therapy (ACT) for pathological gamblers. In the Québec context, this model will serve as a complement to an individual cognitive-behavioral treatment model that has been proven effective and is employed throughout the Canadian province. The assessment of couple therapies could reveal avenues of solutions to better assist pathological gamblers who tend to drop-out of treatment and relapse.
Data were collected for 1998 middle/high-school students in Ontario to assess involvement in gambling, substance use, and generalized risky behavior. To predict these outcomes, measures for anxiety, family cohesion, and coping style were also administered. Three a-priori models were posited to account for the impact of risk factors, protective factors, and combined risk/protective factors on the development of risky behaviors. A high-risk cohort composed of subjects endorsing at least one risky behavior (gambling, substance use, or generalized risky behavior) within the clinical range was created to test an unobserved outcome variable created from all three measures of risky behavior, which was successfully predicted by two of the three a-priori models. Implications for the inclusion of gambling within a constellation of high-risk behaviors and recommendations for future prevention efforts are discussed.
This study describes the extent and distribution of gambling among Norwegian adolescents. The study assesses whether gambling frequency and expenditures and prevalence of problem gambling are associated both at the individual and aggregate (school) level, and in particular whether the total consumption model applies to gambling behaviour. Data comprised a national representative sample of 11,637 13- to 19-year-old students in 73 schools (response rate 92.3%). The Lie/Bet Questionnaire and an additional DSM-criterion on chasing the losses were applied to assess problem gambling. A majority (78.5%) had gambled during the last year and 3.1% met all three criteria for problem gambling. Gambling frequency and expenditures were much higher among problem gamblers and increased proportionally with the degree of problem gambling. The 6.1% who scored on both Lie/Bet items accounted for 59% of all gambling expenditures on slot machines. Positive and significant correlations between various indicators of problem gambling and the overall amount of gambling at the aggregate (school) level imply that the higher the overall amount of gambling and gambling expenditures are, the higher the prevalence of problem gambling, which indicates that the total consumption model also applies to gambling behaviour among adolescents.
The purpose of this review was to summarize the research on adolescent gambling with implications for research and prevention or intervention.
The methodology involved a comprehensive and systematic search of "adolescent or youth gambling" in three diverse electronic databases (MedlineAdvanced, PsycINFO, and Sociological Abstracts) and three peer-reviewed journals (International Journal of Gambling Studies, International Journal of Mental Health and Addiction, and Journal of Gambling Issues).
The search resulted in 137 articles (1985-2010) focusing on gambling among youth aged between 9 and 21 years: 103 quantitative, 8 qualitative, and 26 non-empirical. The study of adolescent gambling can be summarized as follows: (a) it is conducted by a relatively small group of researchers in Britain, Canada, and the United States; (b) it is primarily prevalence-focused, quantitative, descriptive, school-based, and atheoretical; (c) it has most often been published in the Journal of Gambling Studies; (d) it is most often examined in relation to alcohol use; (e) it has relatively few valid and reliable screening instruments that are developmentally appropriate for adolescents, and (f) it lacks racially diverse samples.
Four recommendations are presented for both research and prevention or intervention which are as follows: (1) to provide greater attention to the development and validation of survey instruments or diagnostic criteria to assess adolescent problem gambling; (2) to begin to develop and test more gambling prevention or intervention strategies; (3) to not only examine the co-morbidity of gambling and alcohol abuse, but also include other behaviors such as sexual activity; and (4) to pay greater attention to racial and ethnic differences in the study of adolescent gambling.
This study explored the possible links between family risk factors (i.e., parent gambling and parenting practices) and adolescent gambling. A community sample of 938 adolescents (496 females and 442 males) completed the South Oaks Gambling Screen Revised for Adolescents (SOGS-RA; K. C. Winters, R. Stinchfield, & J. Fulkerson, 1993b) along with a questionnaire assessing parenting practices. Both parents completed the SOGS (H. R. Lesieur & S. B. Blume, 1987). Results showed that adolescent gambling frequency was related to both parents' gambling frequency and problems. However, adolescent gambling problems were linked only to fathers' severity of gambling problems. Low levels of parental monitoring enhanced adolescents' risk of getting involved in gambling activities and developing related problems. A higher level of inadequate disciplinary practices was also related to greater gambling problems in youth. These links were significant after controlling for socioeconomic status, gender, and impulsivity-hyperactivity problems.
Changes in demographical and clinical features of treatment-seeking pathological gamblers, and their gambling preferences before and after the ban of slot machines in Norway from 1 July 2007. Is there an emergence of a new group of gamblers seeking treatment after the ban? The participants were 99 patients, 16 women and 83 men, with the mean age of 35 years. All were referred to the Bergen Clinics Foundation, Norway, for treatment of gambling addiction in the period October 2006 to October 2009. A comprehensive assessment package was applied, focusing on demographical characteristics, the severity of pathological gambling, mental health and substance use disorder. After the ban the mean age was significantly lower, and significantly more were highly educated, in regular employment, and married. Internet gambling and a sport betting game called Odds were the most common options, and gambling problems had become more severe with greater depth due to gambling, bad conscious, heavy alcohol consumption, and more suicidal thoughts and attempts. After the ban of slot machines, the characteristics of treatment-seeking gamblers have been changed, and with great implications for treatment strategies.
To demonstrate the link between gambling, alcohol and drug problems among Ontario adults and to present information on the relationship between expenditures on gambling and type of gambling with gambling problems.
Using data collected in a 1994 telephone survey of 2,016 randomly chosen Ontario adults, gambling problems are related to the CAGE scale of alcohol problems and the ICD-10 measure of alcohol dependence, as well as smoking, other drug use, and demographic variables. Descriptive tables based on crosstabulations and means are provided, as well as a series of 9 logistic regression models.
The most significant predictor of gambling problems was the amount spent on gambling in the preceding 30 days, with alcohol dependence on the ICD-10 scale and age also important predictors. Lottery players, compared to other gamblers, are more likely to be male, relatively less affluent, older on average, more likely to report alcohol problems (but not dependence) and be currently smoking.
The results make clear that heavy drinking and drinking problems are associated with higher levels of spending on gambling and reports of gambling problems. This leads to the suggestion that treatment programs for those with gambling, alcohol or other drug problems should assess that possibility of comorbidity, since the presence of more than one of these problems can significantly affect the success of treatment and contribute to relapse.
Centre de recherche Léa-Roback sur les inégalités sociales de santé de Montréal, Université de Montréal, 1301, rue Sherbrooke Est, Montréal, Canada. eric.robitaille@umontreal.ca
Researchers and public health officials in Canada, the United States and Australia have for some time noted broader geographic accessibility to gambling establishments, above all in socioeconomically underprivileged communities. This increase in availability could lead to more and more gambling problems. This article focuses, in an ecological perspective, in particular on a spatial analysis of the geographic accessibility of sites possessing a VLT permit in the Montréal area, i.e. Montréal Island, the South Shore and Laval, from the standpoint of the development of an indicator of the vulnerability (socioeconomic components and demographic components) to gambling of populations at the level of certain neighbourhood units (dissemination areas). With the recent development of geographic information systems (GIS), it is now possible to ascertain accessibility to services much more accurately, for example by taking into account the configuration of the road network.
The findings of our analysis reveal widespread geographic accessibility to sites possessing a VLT permit in the downtown area and in pericentral districts. In some neighbourhood units, a site possessing a VLT permit may be within a three-minute walk. In the region studied overall, average walking time to a VLT site is nine minutes. Access to this type of service on foot is usually limited in the outskirts. However, a number of groups of sites possessing VLT permits are found along certain axial highways. According to local spatial self-correlation analyses, the findings suggest a significant link between walking accessibility to sites possessing VLT permits and the vulnerability of the communities. In a number of neighbourhood units with ready access to VLT's the populations display high vulnerability.
These findings reveal that accessibility to sites possessing a VLT permit is often linked to the vulnerability (socioeconomic and demographic components) of communities. Reliance in our analyses on neighbourhood units with fairly small areas enabled us to emphasize the rectilinear dimension of the spatial distribution of sites possessing VLT permits. This is a significant link that public health officials must consider when elaborating programs to combat pathological gambling.
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Cites: J Epidemiol Community Health. 2001 Feb;55(2):111-2211154250
This study aimed to examine whether variations among regions in Quebec existed after we controlled for individual characteristics in the prevalence of 1) alcohol, cannabis, and gambling behaviours and 2) substance-related disorders and pathological gambling.
Using data derived from the Canadian Community Health Survey: Mental Health and Well-Being (CCHS 1.2), we nested 5332 respondents from the province of Quebec within 374 regions equivalent to census subdivisions (CSDs). Outcome variables included 1) drinking status (past 12 months), alcohol consumption (last week), and 12-month diagnosis of alcohol dependence; 2) cannabis use (past 12 months and lifetime) and diagnosis of illicit drug dependence; and 3) gambling status, severity of gambling problems, and number of reported gambling activities (past 12 months). Multilevel regression models with individuals (Level 1) nested in regions (CSDs, Level 2) assessed the variations among regions in the prevalence of various outcomes and disorders when individual characteristics were controlled for.
Variance component models revealed that all alcohol-related variables, the prevalence of cannabis use (12 months), and problem gambling did not vary among areas. Gambling rates and the average number of reported gambling activities varied among areas, even when individual-level variables were accounted for in the models, whereas for lifetime cannabis use, variations among areas became nonsignificant.
Intervention programs may need to address the environment as a relevant determinant of health-related behaviours and lifestyles.
The present study examined the factor structure of the Gambling Related Cognitions Scale (GRCS); (Raylu and Oei in Addiction 99:757-769, 2004) in a large sample of adolescents (N = 1,490) between the ages of 16 and 18 years (630 males, 860 females) attending several high schools in central Ontario. Problem gambling was measured using the DSM-IV-J (Fisher in J Gambl Stud 8:263-285, 1992). A 5-factor GRCS model was found to have the best fit to the data, and gambling-related cognitions were found to be powerful predictors of disordered gambling among adolescents. However, strong associations among GRCS subscales, as well as the small amount of variance in problem gambling accounted for by specific GRCS subscales, call into question the multidimensionality of the GRCS when used with adolescents.
