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P r o c e d i a - S o c i a l a n d B e h a v i o r a l S c i e n c e s 7 8 ( 2 0 1 3 ) 5 0 1 – 5 0 5
1877-0428 © 2013 The Authors. Published by Elsevier B.V. Open access under CC BY-NC-ND license.
Selection and/or peer-review under responsibility of PSIWORLD 2012
doi: 10.1016/j.sbspro.2013.04.339
PSIWORLD 2012
Pathological Gambling and Depression
Steliana Rizeanua,b*
aUniversity of Bucharest, Faculty of Psychology and Educational Sciences, Bd. M. Kogalniceanu 050107, Bucharest, Romania
bHyperion University, Psychology Department, Calea Calarasilor 169, Bucharest, 31615 Romania
Abstract
Pathological gambling represents the end spectrum of gambling behaviors. This behavior affects the gambler’s family and the
most obvious consequence of gambli ng problems is a poor private economy. Pathological gamblers were many times more
likely than the general population to report others psychiatric disorders: depression, antisocial personality disorder or history
of alc ohol misuse (Cunningham-Willia ms et al, 19 98). The objective of this study was to explore whether there was a
correlation between gambl ing and depressi on in a sampl e of 119 adults who joined the Responsibl e Gaming Project in
Romania. The results shows that pathological gambling is associated with depression.
© 2012 The Authors. Published by Elsevier B.V.
Selection and/or peer-review under responsibility of PSIWORLD 2012
Keywords: pathol ogical gambling; slot machines; depression; responsib le ga ming project.
1. Problem statement
Gambling is a socially acceptable and legal leisure activity which involves wagering something of value
(usually money) on a game or event whose outcome is unpredictable and determined by chance (Ladoceur et al.,
2002).
The compulsion to gamble progressively takes over an incr easing amount of gambler ’s time, money and
energy.
Those who become addicted to gambling are caught in a serious behavioral disorder that is associated with
depression, anxiety and substance abuse (Rizeanu, 2012).
* Corresponding author. Tel.: +40-74-4757211; fax: +40-21-3222458.
E-mail address: stelianarizeanu@yahoo.co m.
Avai lable o nl ine at www.sciencedirect.com
© 2013 The Authors. Published by Elsevier B.V. Open access under CC BY-NC-ND license.
Selection and/or peer-review under responsibility of PSIWORLD 2012
502 Steliana Rizeanu / Procedia - Social and Behavioral Sciences 78 ( 2013 ) 501 – 505
Pathological gambling can adversely affect the individual, family and society, and also carries high rates of
psychiatric co-morbidity. Depression is probably the most common psychiatric disorder comorbid with
pathological gambling.
A number of previous studies have indicated that pathological gambling is often associated with depression
(Blaszczynski, 2010; Fernández-Montalvo & Echeburúa, 2004; Kessler et al, 2008; Lorains et al., 2011). Equally,
a number of theoretical models of pathological gambling have included depression as a key variable
(Blaszczynski & Nower, 2002; Oei & Raylu, 2008).
Efforts to understand the determinants of problem gambling have led to the examination of a range of
individual factors: biological factors, physical health, temperament and personality factors, psychological states
and disorders and cognitions.
Mood states, par ticularly an xiet y and depression, have been found to be associated with aspects of gambling
behavior and problem gambling.
Using gambling to relieve negative emotional states such as depressed mood and anxiety may be a significant
risk factor for problem devel opment (Abbott, 2001; Blaszczynski & McConaghy, 1989).
A study conducted by Hills, Hill, Mamone & Dickerson (2001) found that depression is a causal factor in
addictive gambling.
In a study of 3,596 individuals, Momper, Delva, Grogan-Kaylor, Sanchez, & Volberg (2010) found that about
33% had experienced at least a depressive symptom; problem gamblers were more likely to experience one
symptom of depression when compared with non-gamblers or those not at risk.
In a Scottish study, pathological gamblers had significantly higher rates of depression than did problem
gamblers, non-problem gamblers, and non-gamblers (Moodie & Finnigan, 2006).
2. Purpose of study
The objective of the present study was to investigate the relationship between pathological gambling and
depressive symptoms in pathological gamblers addicted to slot machines, seeking treatment for problem
gambling.
Clinical research has consistently revealed that up to 75% of compulsive gamblers suffer from symptoms of
major depression (Blaszczynsky, 2010).
The study has the hypothesis that compulsive gambling symptoms and behavior are associated with depressive
symptoms.
Here we report a study of depression in pathological gamblers identified within a sample of 119 adults living
in Bucharest, Romania, who decided to join the Responsible Gaming Project.
3. Research methods
In this study we used a semi-structured interview designed to obtain demographic information and gambling
history, the South Oaks Gambling Screen, the most widely utilized instrument for the general screening of
gambling disorders and th e Beck Depr ession Inventory to evaluate depression.
One hundred and nineteen problem gamblers who joined the Responsible Gambling Project in Romania,
ranging in age from 18 to 61 years, with an average age of 29,86 years, were interviewed (SD=7,453 years). One
hundred an d twelve participants were male and seven were female. In terms of education, 37,8% had a high
school degree whereas 62,2% had either some college or bachelor’ degree; also 95 participants were married,
while 24 were single.
All of the participants were recruited through advertising the Responsible Gaming project in Romania on the
website, help-line an d brochures existing in the gaming halls. Participants defined themselves as problem
gamblers on the basis that their gambling behavior had caused them significan t problems.
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Steliana Rizeanu / Procedia - Social and Behavioral Sciences 78 ( 2013 ) 501 – 505
Face-to-face interviews were conducted during the evaluation session in order to formulate the case and offer
psychological treatment for pathological gambling.
4. Findings
After applying SOGS, all participants obtain ed a mean score on pathological gamblin g of m=10,55 (sd=1,78),
thus revealing that all of them were pathological gamblers.
Analyzing the scores, the histogram shows a slight tilt to the left and a platykurtic distribution of the curve,
which states that the scores are scattered around the central value (see figure 1. a).
Fig. 1. (a) Hi stogram – Initial SOG S scores (N=119); (b) Histo gram – Initial BDI scores (N=119)
The initial sample (N=119) obtained a mean score on depression of m=19 (sd=9,2), a value which is situated
in the moderate depression area. In this sample, scores ranged from 6 points minimum score (normal state) and
the maximum score of 43 points (severe depression). The score with the highest frequency, the mode, was the
value 9.
The histogram shows a slight tilt to the left and a platykurtic distribution of the curve, which states that the
scores are scattered around the central value (see figure 1.b).
Fig. 2. Initial depression (BDI) scores distribution (N=119)
504 Steliana Rizeanu / Procedia - Social and Behavioral Sciences 78 ( 2013 ) 501 – 505
Out of 119 pathological gamblers, 76.47% were found with different symptoms of depression; 28.57%
presented mild depression; 34.45% moderate depression and 13.45% severe depression (see figure 2).
During the pathological gambling treatment offered within The Responsible Gaming Project (Rizeanu, 2012),
from the original group (N=119), only 53% of the subjects (N=63) remained within the program until the end.
The final sample was divided in 2 gr oups based on the origin al SOGS scor es. Group 1 (N=28) had subjects
with SOGS scores equal to or above 10 points, and the second group (N=35) had subjects with SOGS bellow 10
points.
The Beck scores of pathological gamblers were positively correlated with the pathological gambling as
indicated by the scores of South Oak Gambling Screen - SOGS. A correlation between depressive and gambling
symptoms was found amongst the 2 study groups: r(28)=0.783; p=0,001 (two-way); r(35)=0.723; p=0,009 (two-
way).
As gamblin g is often used to escape negative emotion states, numerous studies have found that negative
emotional states and related psychological disorders (e.g depressive) play a role in the development and
maintenance of pathological gambling (Boughton & Falenchuk, 2007; Dougherty et. al., 2004; El-Guebaly et al.,
2006; Moodie & Finnigan, 2006).
Depression is very common in problem gamblers and some symptoms of depression include emotional state,
thought process, social functioning and physical well-being (Korn & Schaffer, 2004; Raylu & Oei, 2010;
Rizeanu, & S voiu, 2012).
Clarke (2006) reported that impulsivity mediated the pass of depression to problem gambling severity.
5. Conclusions
The extend of problem gambling among youth in Romania is estimated to be ar ound 6,8% of adolescents
(Lupu et. al, 2002).
This research supports the existence of a positive correlation between pathological gambling and depression
among pathological gamblers presenting for treatment. Validity studies are required in order to verify the
correlation between the pathological gambling and depr ession to Romanian gamblers.
Improved awareness among health pr ofessionals of problem gambling can lead to early recogn ition and
treatment, thus limiting the more severe adverse consequences.
McCown and Chamberlain (2004) suggested that psychologists who specialize in the treatment of gambling
disorders are among the poorest paid mental health practitioners, regardless of their training.
One limitation of this study was that it finally involved only 63 participants, although, for a qualitative study
of this kind it is quite a large sample; by surveying much larger numbers of the general population it would be
possible to include a number of problem gamblers.
These findings suggest that interventions aimed at helping gamblers also need to involve careful attention to
the depressive symptoms that gambler s experience.
In the future, prevention plans and treatment interventions should aim to increase the gambler’s contact with
non-gambling peers and non-gambling activities.
Unfortunately, there are very few resour ces and absence of sufficient numbers of trained clinicians to provide
necessary services to the population and the number of people affected by problem gambling is certainly
increasing.
In Romania, public policy related to gambling aims at the prohibition of online gambling activities and
ensures the prohibition of access to gaming services to minors (those under 18 years of age) but also ensure that
gambling services are not advertised on mainstream media.
A responsible gambler is a person exercising a rational and sensible choice an d acting upon that choice based
on his/her individual circumstances and awareness of th e intention of th e entertainment experience and its
limitations.
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Steliana Rizeanu / Procedia - Social and Behavioral Sciences 78 ( 2013 ) 501 – 505
Problem gamblers are at great risk of relationship breakdown, poor physical health, mental-health problems
such as anxiety, depression and suicide.
Acknowledgements
This study was funded by the Responsible Gaming Project in Romania. The author would like to thank
Novomatic and Romslot for their assistance in completing this study.
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