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Traumata, traumatogene Faktoren und pathologisches Glücksspielen

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Abstract

Im Hinblick auf soziodemografische Daten, anamnestische Traumata und potenziell traumatogene Faktoren wurden 100 männliche mit 100 weiblichen pathologischen Glücksspielern verglichen. Beide Populationen befanden sich zur spezifischen stationären Therapie in der AHG Klinik Münchwies. Die weibliche Stichprobe fiel durch einen späteren Glücksspielbeginn, eine raschere Progression des Krankheitsverlaufs sowie durch eine wesentlich höhere Traumatisierungsquote (Vernachlässigung, körperliche Misshandlungen, sexueller Missbrauch und andere Traumata in Kindheit und Erwachsenenalter) auf. Körperliche Gewalttätigkeiten der Mütter, ein jüngeres Alter bei den Scheidungen der Eltern sowie eine erhöhte Quote an erlittener Gewalt in der Partnerschaft und an Suchterkrankungen der Partner unterschieden weiterhin die weibliche von der männlichen Stichprobe signifikant. This study compared 100 female pathological gamblers with 100 male pathological gamblers with respect to sociological data, previous trauma and potential traumatogenic factors. All pathological gamblers were inpatients of the German clinic of Muenchwies. The female sample showed later onset of gambling, faster progression into a pathological disorder and higher rates of traumatisation in childhood as well as in adult age (e.g. parental neglect, physical and sexual abuse). Furthermore, significantly higher rates of maternal violence, younger age at the time of parental divorce, higher rates of violence in a partnership and addiction of the partner also differentiated the female sample from the male sample.

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... We identified 11 studies providing information on sex differences for sociodemographic variables (Blanco et al., 2006;Bonnaire et al., 2016Bonnaire et al., , 2017Castrén, Kontto, Alho, & Salonen, 2018;Granero et al., 2009;Grant, Chamberlain, Schreiber, & Odlaug, 2012;Guillou-Landreat et al., 2016;Hing, Russell, Tolchard, & Nower, 2016;Jiménez-Murcia et al., 2020;Ronzitti, Lutri, Smith, Clerici, & Bowden-Jones, 2016;Vogelgesang, 2009). Education, income, employment status, and household composition were defined as variables of interest. ...
... Concerning unemployment, two of three studies found women more likely to be unemployed Ronzitti et al., 2016). Only Vogelgesang (2009) reported equivalent unemployment levels for men and women with PG, which, however, refer to a small sample size. Four studies on general population samples reported differences in household composition (Blanco et al., 2006;Bonnaire et al., 2016Bonnaire et al., , 2017Hing et al., 2016), whereas one study among a clinical sample found no differences (Grant, Chamberlain, et al., 2012). ...
... We found 16 studies that explored the relationship between sex, gambling, and violence (Andronicos et al., 2015;Afifi, Brownridge, MacMillan, & Sareen, 2010;Cunningham-Williams, Abdallah, Callahan, & Cottler, 2007;Dowling et al., 2014Dowling et al., , 2016Dowling et al., , 2018Dowling et al., , 2019Echeburúa et al., 2011;Fröberg et al., 2013;Kausch et al., 2006;Korman et al., 2008;Lee, Storr, Ialongo, & Martins, 2012;Roberts et al., 2016;Suomi et al., 2019;Vogelgesang, 2009Vogelgesang, , 2013. Pathological gambling was found to be associated with a higher likelihood of being the victim and the perpetrator of violence (psychological, physical, and sexual violence) (Afifi et al., 2010;Roberts et al., 2016;Suomi et al., 2019). ...
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Background and aim A wide range of studies indicates that men and women with Problem (PrG) and Pathological Gambling (PG) differ in several clinical and sociodemographic characteristics. However, evidence for sex differences, such as the telescoping effect, is contradictory, and it is still unclear whether sex differences observed in offline gambling can also be found for online gambling. Furthermore, reviews have so far focused on binary sex differences but neglect gender aspects. In this study, an updated literature survey of sex- and gender-related differences in PrG and PG was conducted. Methods We searched PsyInfo, Medline/Pubmed, and the Web of Science databases from 2005 to 2020 for studies investigating sex and gender differences in gambling. A total of 126 papers were included in the literature survey. Results We are presenting our findings according to the categories ‘prevalence’ (offline, online, LGBTQI*), ‘sociodemographic factors’, ‘preferred gambling type’, ‘gambling motives’, ‘severity’, ‘progression of gambling problems’, ‘use of professional help/motivation for treatment’, ‘comorbidity’, ‘trauma’, ‘violence and criminality/delinquency’. The studies indicate that, despite some robust sex differences (e.g., concerning prevalence rates), results for most areas were mixed or suggest no sex differences (e.g., violence, gambling motives). Discussion and conclusion To date, there is a lack of studies assessing gender, and not only sex, warranting further research in this area.
... We identified seven cohort studies that did not include a comparison group of non-gamblers (Bland, Newman, Orn, & Stebelsky, 1993;Ciarrocchi & Richardson, 1989;Ibáñez, Blanco, Moreryra, & Sáiz-Ruiz, 2003;Johnson, Nora, & Bustos, 1992;Lesieur & Rothschild, 1989;Petry & Steinberg, 2005;Vogelgesang, 2010). Five of the seven examined gambler's own history of maltreatment (Ciarrocchi & Richardson, 1989;Ibáñez et al., 2003;Johnson et al., 1992;Petry & Steinberg, 2005;Vogelgesang, 2010). ...
... We identified seven cohort studies that did not include a comparison group of non-gamblers (Bland, Newman, Orn, & Stebelsky, 1993;Ciarrocchi & Richardson, 1989;Ibáñez, Blanco, Moreryra, & Sáiz-Ruiz, 2003;Johnson, Nora, & Bustos, 1992;Lesieur & Rothschild, 1989;Petry & Steinberg, 2005;Vogelgesang, 2010). Five of the seven examined gambler's own history of maltreatment (Ciarrocchi & Richardson, 1989;Ibáñez et al., 2003;Johnson et al., 1992;Petry & Steinberg, 2005;Vogelgesang, 2010). Participants from all five of these studies were enrolled from problem gambling treatment programs (Ciarrocchi & Richardson, 1989;Ibáñez et al., 2003;Johnson et al., 1992;Petry & Steinberg, 2005;Vogelgesang, 2010). ...
... Five of the seven examined gambler's own history of maltreatment (Ciarrocchi & Richardson, 1989;Ibáñez et al., 2003;Johnson et al., 1992;Petry & Steinberg, 2005;Vogelgesang, 2010). Participants from all five of these studies were enrolled from problem gambling treatment programs (Ciarrocchi & Richardson, 1989;Ibáñez et al., 2003;Johnson et al., 1992;Petry & Steinberg, 2005;Vogelgesang, 2010). Rates of childhood physical abuse in these samples ranged from 13 to 27%. ...
Article
This study systematically reviews research on child maltreatment and risk of gambling problems in adulthood. It also reviews adult problem gamblers' risk of abusing or neglecting their own children. Multiple database searches were conducted using pre-defined search terms related to gambling and child abuse and neglect. We identified 601 unique references and excluded studies if they did not report original research, or did not specifically measure child maltreatment or gambling. Twelve studies that included multivariable analysis of childhood maltreatment exposure and problem gambling were identified. Six of seven studies examining childhood sexual abuse and four of five examining physical abuse showed a significant positive association between abuse and later gambling problems (odds ratios for sexual abuse 2.01-3.65; physical abuse 2.3-2.8). Both studies examining psychological maltreatment and two of three examining neglect identified positive associations with problem gambling. In most studies, risks were reduced or eliminated when controlling for other mental health disorders. The three studies measuring risk of child abuse and neglect among current problem gamblers suggest an increased risk for child physical abuse and medical conditions indicative of neglect although there is a considerable amount of variation among studies. Child abuse is associated with increased risk of gambling problems - gambling treatment providers should ask about maltreatment history as part of their clinical assessment. Problem gamblers may be more likely to physically abuse or neglect their children, but data here are more limited. Child welfare professionals should consider asking questions about parental gambling when assessing family risk.
... Lane et al., 2016). Conversely, among gamblers seeking treatment, high rates of ACEs are reported: 46-57% report childhood emotional abuse (Kausch, Rugle, & Rowland, 2006); 17-67% report neglect (Scherrer et al., 2007;Vogelgesang, 2010); 13-41% report physical abuse (Ibáñez, Blanco, Moreryra, & Sáiz-Ruiz, 2003;Kausch et al., 2006;Scherrer et al., 2007); and 17-25% report sexual abuse (Kausch et al., 2006;Scherrer et al., 2007;Vogelgesang, 2010). ...
... Lane et al., 2016). Conversely, among gamblers seeking treatment, high rates of ACEs are reported: 46-57% report childhood emotional abuse (Kausch, Rugle, & Rowland, 2006); 17-67% report neglect (Scherrer et al., 2007;Vogelgesang, 2010); 13-41% report physical abuse (Ibáñez, Blanco, Moreryra, & Sáiz-Ruiz, 2003;Kausch et al., 2006;Scherrer et al., 2007); and 17-25% report sexual abuse (Kausch et al., 2006;Scherrer et al., 2007;Vogelgesang, 2010). ...
Article
Despite of high rates of adverse childhood experiences (ACEs) in pathological gamblers, researchers have rarely studied which types of ACEs often co-occur and how these profiles of ACEs are related to current psychopathology. We aimed to identify profiles of ACEs in pathological gamblers and examined how these profiles were related to gambling-related characteristics and current general psychopathology. In 329 current or lifetime pathological gamblers, diagnosed with the Composite Diagnostic Interview for DSM-IV, 10 types of ACEs were measured using the Adverse Childhood Experiences Questionnaire. Global psychopathology was assessed using the Symptom Checklist SCL-27. ACE profiles were identified using latent class analysis. Differences between ACE profiles in gambling-related characteristics and global psychopathology were analyzed using MANOVA. We found that four out of five gamblers (n=257, 78.1%) reported at least one ACE. Four distinct ACE profiles were identified: 'Low ACE', 'High ACE', 'Physical and emotional abuse', and 'Neglect'. The number of the fulfilled pathological gambling criteria and the severity of current global psychopathology differed between the ACE profiles: Gamblers with a 'High ACE' profile fulfilled more pathological gambling criteria and showed a more severe current psychopathology than gamblers of the 'Low ACE' profile. Gamblers with a 'Physical and emotional abuse' or an 'Emotion neglect' profile showed an intermediate severity of psychopathology. Our findings indicate that four different ACE profiles can be distinguished in pathological gamblers that differed in their gambling-related characteristics and current psychopathology. Systematic assessment of profiles of ACEs in pathological gamblers may inform about the severity of current global psychopathology that might be important to be addressed in addition to gambling-specific treatment.
... Previous studies characterised people with gambling disorder as a clientele with high psychiatric comorbidity burden and substantial co-consumption of psychotropic substances (Mann et al., 2017;Premper & Schulz, 2008;Vogelgesang, 2010). These co-issues might introduce additional complexity into gambling-related addiction care and presumably affect its effectiveness: less than 50% of patients with gambling disorder stay abstinent during the first year after inpatient rehabilitation (Bundesverband für stationäre Suchtkrankenhilfe e.V (buss), 2015; Muller et al., 2017;Premper et al., 2014). ...
Article
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Objective The prospective naturalistic study ‘Katamnese‐Studie’ conducted between 2014 and 2019 gathers evidence on the course of gambling disorder in German routine outpatient addiction care. This study elucidates design and methodological advantages and caveats of the study. Methods Participants of the multi‐centre cohort received written questionnaires at admission and at 6‐, 12‐, 24‐ and 36‐month follow‐up to assess socio‐demographic data, gambling behaviour, gambling‐related consequences and care offers sought. Subsequently, self‐reports were linked to client‐individual routine documentation for the German Addiction Care Statistical Service. Furthermore, employees of participating outpatient addiction care facilities were surveyed regarding experiences with and attitudes towards gambling disorder. Multivariate longitudinal regression models will portray changes in the severity of gambling disorder and gambling behaviour and explore associated client‐ and care‐related factors. Conclusion The ‘Katamnese‐Studie’ covers the whole spectrum of outpatient gambling care. Keeping the design‐related caveats in mind (reliability of self‐reports, loss‐to‐follow‐up and issues regarding causal inference), the study is anticipated to draw a comprehensive picture of routine outpatient gambling care and key factors related to sustained remission. In the medium term, this information might support the development and subpopulation‐specific adaptation of recommendations on how to structure process and content of outpatient gambling care.
... Previous studies characterised people with gambling disorder as a clientele with high psychiatric comorbidity burden and substantial co-consumption of psychotropic substances (Mann et al., 2017;Premper & Schulz, 2008;Vogelgesang, 2010). These co-issues might introduce additional complexity into gambling-related addiction care and presumably affect its effectiveness: less than 50% of patients with gambling disorder stay abstinent during the first year after inpatient rehabilitation (Bundesverband für stationäre Suchtkrankenhilfe e.V (buss), 2015; Muller et al., 2017;Premper et al., 2014). ...
Article
Einleitung: In ambulanten Suchthilfeeinrichtungen steigt die Zahl der Klienten mit Glucksspielproblemen (Braun et al., 2014, Sleczka et al., 2014, Meyer, 2014). So hat sich die durchschnittliche Anzahl betreuter Glucksspieler von 3,2 im Jahr 2000 auf 14,7 im Jahr 2012 erhoht (Meyer, 2014). Allerdings gibt es in Deutschland nur sehr wenige allgemeingultige Leitlinien fur die ambulante Versorgung von Personen mit Glucksspielproblemen (Braun et al., 2013), sodass Unterschiede hinsichtlich der Inhalte und angewandten Methoden innerhalb der Beratung/Behandlung zu erwarten sind. Nur wenige Studien untersuchten die ambulante Beratung/Behandlung von Personen mit Glucksspielproblemen prospektiv (vgl. Ramos-Grille et al., 2013). Fur die Weiterentwicklung der ambulanten Versorgungsstrukturen ist es wichtig, Erkenntnisse uber Faktoren zu gewinnen, die mit dem Storungsverlauf und Behandlungsergebnis assoziiert sind. Hierzu zahlen neben klientenbezogenen Faktoren auch beratungs-/behandlungs- und beraterbezogene Faktoren. Methoden: Katamnese Studie an 29 ambulanten Suchthilfeeinrichtungen in Bayern. Auswertungen zu Beratungs-/Behandlungs- und Beratermerkmalen anhand einer Mitarbeiterbefragung mit einem Stichprobenumfang von n = 45. Schriftliche Befragung zu Qualifikationen, Erfahrungen und Einstellungen sowie zu den Leistungen der Einrichtung. Ergebnisse: Mitarbeiter ambulanter Suchthilfeeinrichtungen unterscheiden sich bezuglich ihrer Qualifikationen und Erfahrungen in der Beratung/Behandlung von Personen mit Glucksspielproblemen. Die Mitarbeiter arbeiten durchschnittlich 6,6 Jahre (SD = 5,9) in der Beratung von Glucksspielern und betreuten im Durchschnitt 109 Klienten (SD = 154,7) mit Glucksspielproblemen. Zwei Drittel der Mitarbeiter sehen Unterschiede in der Beratung/Behandlung von Glucksspielern im Vergleich zu Personen mit substanzgebundenen Storungen. Als zentrale Unterschiede wurden u.a. eine hohere Abbruchquote, grosere Schwierigkeiten eine therapeutische Beziehung aufzubauen, fehlende Krankheitseinsicht und erhebliche Auswirkungen auf die Existenz und das soziale Umfeld benannt. Diskussion: Es bestehen grose Unterschiede zwischen Mitarbeitern ambulanter Suchthilfereinrichtungen hinsichtlich ihrer Erfahrungen und Einstellungen in der Beratung/Behandlung von Personen mit Glucksspielproblemen. Auserdem bewertet die Mehrheit der Mitarbeiter die Beratung/Behandlung von Personen mit Glucksspielproblemen als schwierig. Es ist notwendig, den Einfluss von Berater- und Beratungs-/Behandlungsmerkmalen auf den Storungsverlauf und das Behandlungsergebnis zu untersuchen. Gemeinsam mit Erkenntnissen uber klientenrelevante Einflussfaktoren auf den Storungsverlauf und das Behandlungsergebnis sollen Best-Practice-Empfehlungen fur die ambulante Beratung und Behandlung von Personen mit Glucksspielproblemen entwickelt werden.
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Zusammenfassung. Ziel: Beim pathologischen Glücksspielen wurden vereinzelt Einbußen in der Partnerschaftszufriedenheit und Geschlechterunterschiede gefunden. Im deutschsprachigen Raum fehlt eine zusammenführende Studie beider Variablen bisher. Daher soll die Rolle von Partnerschaftsstatus und Geschlecht für die psychische Belastung und die Partnerschaftszufriedenheit untersucht werden, um einen empirischen Beitrag zur bedarfsorientierten Behandlung zu leisten. Methodik: Es wurden routinemäßig erhobene Daten einer stationären Rehabilitationsklinik genutzt. Patientinnen und Patienten mit pathologischem Glücksspielen als Hauptdiagnose (N = 392; Ausschöpfungsquote 75 %) machten Angaben zur Soziodemografie, störungsspezifischer und -unspezifischer psychischer Belastung und Partnerschaftszufriedenheit. Ergebnisse: In der Partnerschaftszufriedenheit wurden leichte Einbußen gefunden, besonders im Streitverhalten. Das Geschlecht erklärte einen bedeutsamen Anteil der psychischen störungsunspezifischen Belastung, Frauen zeigten höhere Werte. Partnerschaftsstatus und die Interaktion aus Partnerschaftsstatus und Geschlecht erklärten keinen bedeutsamen Anteil an der psychischen Belastung. Schlussfolgerungen: Bei Betroffenen in Partnerschaft sollte die Dimension „Streitverhalten“ auf Relevanz für die Therapieindikation geprüft und ggf. in die Behandlung mit aufgenommen werden. Der relevante Beitrag des Geschlechts zur psychischen Belastung sollte für die Behandlungsplanung pathologischer Glücksspielerinnen berücksichtig werden.
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pathological gamblers are persons who have a chronic and progressive failure to resist impulses to gamble, a failure that compromises, disrupts and damages personal, family and/or vocational pursuits / the principal features are emotional dependence on gambling, loss of control and interference with normal functioning recently established inpatient and outpatient programs have followed an addictions treatment model, including use of the Twelve Step programs women who have gambling problems are an underserved group / part of the reason for the underrepresentation of women in treatment and self-help is society's stereotype of the gambler reviews the findings of Lesieur's study of 50 women pathological gamblers / the study . . . was based on intensive interviews with female GA [gamblers anonymous] members from across the US / probed for information about their gambling histories, the intersection of family, work, financial, emotional and other factors, and the relation between gambling and other addictions epidemiological surveys / background characteristics / phases in the career of the female pathological gambler / help seeking behavior / feminist perspectives on women and compulsive gambling / screening the female pathological gambler / treatment of compulsive gambling in women (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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This study investigated gender differences among treatment-seeking pathological gamblers. During treatment intake, 115 pathological gamblers completed the Addiction Severity Index (ASI; A. T. McLellan et al., 1985), including a section on gambling severity, as well as the South Oaks Gambling Screen (H. R. Lesieur & S. B. Blume, 1987). When age and income were controlled, gender differences emerged in ASI gambling, alcohol, and legal scores. Men initiated gambling, began gambling regularly, tried to stop gambling, and first entered gambling treatment at a younger age than women. Women were more likely to be living with someone with a gambling or drinking problem but themselves had fewer alcohol and legal problems. Results suggest that gender differences exist in the initiation of gambling dysfunction and its psychosocial correlates. Understanding these differences may assist in developing treatments that address differential needs of male and female pathological gamblers.
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To determine the differences in clinical presentation, gambling behavior, and psychiatric comorbidity of male and female treatment-seeking pathological gamblers. Sixty-nine consecutive individuals with DSM-IV pathological gambling (47 men and 22 women) applying to a specialized out-patient treatment program were evaluated with structured interviews, self-report questionnaires, and psychological scales. Sixty-seven percent of men (N = 26) versus 25% of women (N = 5) had been exposed to gambling in adolescence. Women had a later age at first bet and a faster evolution of the disorder. Female pathological gamblers were more likely to play bingo, whereas men tended to prefer slot machines. Male and female pathological gamblers had similar gambling severity and overall rates of psychiatric comorbidity. However, male pathological gamblers had higher rates of alcohol abuse/dependence and antisocial personality disorder, whereas women had higher rates of affective disorders and history of physical abuse. There are substantial gender differences in the clinical presentation and comorbidity of pathological gambling. These gender differences should be incorporated in the selection and planning of treatment for pathological gamblers.
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Depression and maladaptive coping styles are important components of theories of pathological gambling and are frequently foci of treatment with individuals with gambling problems. The present study aimed to improve understanding and treatment of pathological gambling by comparing levels of depression and styles of coping in male and female members of Gamblers Anonymous (GA) to a group of non-pathological gambling controls matched according to gender, age, education, and income. Pathological gambling was measured by the South Oaks Gambling Scale, depression by the Beck Depression Inventory, and coping styles by the Problem-Focused Styles of Coping inventory. Results showed that GA members reported significantly higher levels of depression and more maladaptive styles of coping than controls. Pathological gamblers' greater use of maladaptive coping was evident even when variance attributable to depression was removed, suggesting that their coping deficits may be pervasive. Female subjects reported significantly greater levels of depression and maladaptive coping than their male counterparts. Implications for treating depression and coping styles in pathological gamblers are discussed.
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Previous studies of problem gamblers portray this group as being almost exclusively male. However, this study demonstrates that females comprised 46% of the population ( n = 1,520) of persons who sought assistance due to concerns about their gambling from the publicly-funded BreakEven counselling services in the state of Victoria, Australia, in one 12-month period. This suggests that the model of service delivery which is community based counselling on a non-residential basis may be better able to attract female clients than treatment centres where males predominate such as veterans centres. A comparative analysis of the social and demographic characteristics of female and male gamblers within the study population was undertaken. As with previous studies, we have found significant differences between males and females who have sought help for problems associated with their gambling. Gender differences revealed in this study include females being far more likely to use electronic gaming machines (91.1% vs. 61.4%), older (39.6 years vs. 36.1 years), more likely to be born in Australia (79.4% vs. 74.7%), to be married (42.8% vs. 30.2%), living with family (78.9% vs. 61.5%) and to have dependent children (48.4% vs. 35.7%), than males who present at these services. Female gamblers (A$7,342) reported average gambling debts of less than half of that owed by males (A$19,091). These gender differences have implications for the development and conduct of problem gambling counselling services as it cannot be assumed that models of service which have demonstrated effectiveness with males will be similarly effective with females.
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A total of 952 (841 men and 111 women) Chinese treatment-seeking problem gamblers completed self-report assessment forms. Female in contrast to male gamblers were more likely to be older, married, less educated, and without employment. Female gamblers also started gambling at an older age, had a shorter gambling history, preferred casino and mahjong gambling, and reported more somatic complaints and suicidal thoughts. Male and female gamblers accumulated similar amount of gambling debt and reported an average of 12 gambling-related problems on the Chinese version of the South Oaks Gambling Screen [Lesieur and Blume (Am J Psychiatry 144:1184-1188, 1987)]. Both groups were similarly troubled by their indebtedness, inability to control gambling, and gambling-related interpersonal problems. However, female gamblers had fewer means to pay their gambling debt. Given that significant gender-related differences were observed in Chinese problem gamblers, prevention and treatment services should attend to specific needs of male and female gamblers.
Article
This study helps to address a deficiency of gender-specific research into problem gambling. It focuses on the gambling behaviors, family and personal histories and comorbid psychological disorders of 365 female gamblers from across Ontario, Canada, who responded to a mail-in survey. Specifically, this study looks at rates of depression and anxiety, concurrent struggles with other behaviors (such as alcohol and drug use, disordered eating, overspending and criminal activity) and abuse history reported by female gamblers. The reported rates are considerably higher than for the general female population. The findings of this study agree with previous research. They suggest that prevention strategies and treatment practices for female problem gamblers should take into account women's mental health, addiction and trauma history as contributing factors in the development of problematic gambling.
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