Article

Problem gambling, anxiety and poverty: an examination of the relationship between poor mental health and gambling problems across socio-economic status

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Abstract

Socio-economic status has been shown to be significantly related to both problem gambling and mental health problems. Additionally, forms of psychopathology such as mood and anxiety disorders have been shown to correlate with problem gambling across a variety of settings. However, relatively little research has been conducted examining whether the connection between mood and anxiety disorders and problem gambling is consistent across different levels of socio-economic status. This study examines gambling-related problems among a representative sample of Canadian adults using the 2008 Canadian Community Health Survey (N = 28,271). Generalized linear modelling is used to analyze the data. A moderation effect is found that shows the relationship between anxiety disorders and problem gambling severity varies significantly across socio-economic status. This study shows that social setting has an important influence on the assumed relationship between psychopathology and gambling problems that is downplayed in current problem gambling research. A discussion of the need for greater inclusion of socio-economic context when making assumptions about the connections between problem gambling and psychiatric disorders is made in light of the responsibilities of gambling providers and regulators.

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... Previous studies among Cambodian refugees, (Marshall et al., 2009) veterans in Australia, (Biddle, Hawthorne, Forbes, et al., 2005) and prison inmates in the US (Templer, Kaiser, & Siscoe, 1993) identified stress, substance abuse, and poor mental health to be associated with gambling disorders. Collectively, these studies provide evidence that gambling disorders may be comorbid with other psychosocial burdens, particularly among marginalized populations (Biddle et al., 2005;Currie, Wild, Schopflocher, et al., 2013;Jacques & Ladouceur, 2006;Pearce, Mason, Hiscock, & Day, 2008;Templer et al., 1993;van der Maas, 2016). Due to high living costs, minority stress, and isolation from support networks, migrant workers in Macao encounter substantial psychosocial and financial challenges. ...
... Health status was self-reported as very good, good, normal, poor, or very poor. Psychosocial measures of perceived social support and symptoms of depression and anxiety were assessed based on the Multidimensional Scale of Perceived Social Support (MSPSS) (Zimet, Dahlem, Zimet, Dahlem, Zimet, et al., 1988) (Cronbach's Alpha = 0.97), Patient Health Questionnaire (PHQ-9) (Kroenke, Spitzer, & Williams, 2001) (Cronbach's Alpha = 0.89), and Generalized Anxiety Disorder (GAD-7) (Spitzer, Kroenke, Williams, et al., 2006) (Cronbach's Alpha = 0.92), respectively. Based on PHQ-9 standards, depression severity among the sample was categorized as none, mild, moderate, moderately severe, and severe. ...
... First, the population receives a modest salary and experiences pressuresinternal and externalto send remittances to multiple dependents back home. The urge to gamble may follow from a desire for income generation (Nower & Blaszczynski, 2010;van der Maas, 2016). The identity of the migrant worker is as a provider for their family; threats to this role may motivate compensatory behaviors, like gambling or transactional sex (Hall, Garabiles, & Latkin, 2019). ...
Article
Background and Aims Correlates and risk factors for gambling disorder among vulnerable or transient populations such as transnational migrant workers are unknown. The current study examined sociodemographic and spatial correlates of gambling disorder among female Filipino domestic workers in Macao (SAR), China. Design Survey-based, respondent-driven sampling study administered from November 2016 to August 2017. Setting Macao (SAR), which encompassed 38 casinos within its 30.4 km2 area at the time of this study. Participants Representative sample of N=1194 female Filipino domestic workers in Macao. Measurements Symptoms of gambling disorder based on Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Correlates evaluated included sociodemographic information, proximity to venues, perceived social support, and symptoms of depression and anxiety. Findings Prevalence of gambling disorder was 5.1%. Multivariable regression analyses indicated that likelihood of gambling participation (i.e., ever gambling) was associated with current indebtedness (RR=1.56, 95%CI=1.08-2.25, p=0.017) and worse self-reported health (RR=1.31, 95%CI=1.04-1.65, p=0.02). Increased symptoms of gambling disorder were independently associated with lower perceived social support (RR=0.92, 95%CI=0.87-0.98, p=0.006), increased dependents relying upon monthly remittances (RR=1.10, 95%CI=1.06-1.16, p<0.001), increased depression severity (RR=1.16, 95%CI=1.07-1.25, p<0.001), decreased salary quintile (RR=0.97, 95%CI=0.94-1.00, p=0.04), and proximity to the nearest Mocha Club gaming venues (RR=1.04, 95%CI=1.02-1.07, p=0.005). The association between proximity to casinos and increased symptoms of gambling disorder was significant only for domestic workers living apart from employers (RR=1.07, 95%CI=1.00-1.14, p=0.04). Conclusions Increased spatial proximity to gambling venues and greater financial and psychosocial burdens appear to be associated with gambling disorder among domestic workers in Macao.
... 101-102.) Neglecting the connection between problem gambling and larger social structures is troubling, especially in richer countries which have witnessed the recent expansion of gambling (Maas, 2016). ...
... As financial strain is one of the central consequences of gambling, the socio-economic positions of gamblers and problem gamblers are relevant: financial loss is a definite harm caused by gambling, and it is costlier for some than for others (Maas, 2016). For example, higher income problem gamblers are able to postpone bankruptcy for longer than those on lower incomes (Reith, 2007). ...
... People who experienced health problems used more money on gambling than people who did experience their health good (Salonen et al., 2017a). In Canada, people in higher levels of the socio-economic hierarchy experienced fewer problems because of their gambling participation (Maas, 2016). Australian unemployment and sickness benefit recipients had a greater probability of engaging in gambling than others (Layton & Worthington, 1999), and people receiving community assistance (mainly social assistance) in North America had a higher prevalence of gambling disorders than the general population (Lepage, Ladouceur & Jacques, 2000). ...
Thesis
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The purpose of this study is to discuss problem gambling as a financial issue, to study the everyday life (unbalanced) budgets and financial matters of problem gamblers, and to discover their financial recovery processes, with or without the support from state public welfare services. In practice, the results of this study aim to support the development of prevention of problem gambling and services (especially financial support) for people who have experienced problems with their gambling. Using three data sets, this research asks: what gambler consumer clusters can be identified in Finland? How do problem gamblers experience financial problems as being secondary to gambling? How do they perceive the assistance available in deteriorating financial situations, partly related to their socio-economic positions? What meanings do Finnish social services directors gice to the public (financial) support available for problem gamblers? First, the main data set comprises 17 thematic interviews with individuals who have experienced problematic gambling. The second data set includes 11 email and phone interviews with different-level social services directors in the most populous cities in Finland, while the third data set is a population survey entitled “Finnish Gambling 2011”. First, three problematic issues connected to money during different phases of problem gambling are identified: needing money for gambling, missing money due to gambling and potential money to sort out the problems caused by gambling. The everyday life financial affairs and practices described by the gamblers revealed the episodic nature of problem gambling: disposable money means that gambling activities are organized temporally. Second, this thesis shows that gamblers in general are heterogeneous consumers. Problem gambling is most common among gamblers who play many different games. Problem gamblers come from different socio-economic backgrounds, which results in variations in the nature of the financial problems in the everyday life of the gamblers and their households. Also, their paths to financial recovery vary, especially regarding public financial assistance and social services in general, as problem gamblers have different subjective “distances” from public services. Third, problem gamblers themselves may conceptualize their problems as financial and feel that their concerns are left unaddressed in treatment. Also, measures to recognize problem gambling within social services seem necessary. The social service directors expressed the view that financial support is available for problem gamblers but requires resources, especially for the more controlling measures such as having a social worker manage the client’s finances. Control in general is an important element in supporting problem gamblers financially, as different money-management strategies may influence the gambler’s financial autonomy, but may provide support in managing financially. Problem gambling is often understood as a mental health issue and treated with individual therapy. This study suggests that the prevention and treatment of problem gambling ought to be set in a broader, financial perspective. Gambling is undertaken with money, and the cycles of everyday life budgets, as well as the different social and economic positions of the gamblers, should be recognized and acknowledged.
... Current debates are particularly focused on whether CSBD should be classified as a behavioral addiction or an impulse control and obsessive-compulsive spectrum disorder (Sassover & Weinstein, 2020;Sussman et al., 2020). Research, measures, and diagnostic criteria have included obsessive-compulsive characteristics in the conceptualization of CSBD, thus giving an indication that it may be closely related to Obsessive Compulsive Disorder (OCD; Fuss et al., 2019). ...
... Alternatively, CSBD appears to show some of the same neural responses to sexual cues as drug addiction shows to drug cues (Kowalewska et al., 2018;Stark et al., 2018;Voon et al., 2014). CSBD also appears to have other similar symptoms to addictive disorders, including Gambling Disorder, such as a distressing inability to stop or cut down (Kraus et al., 2016;Sussman et al., 2020). ...
Article
The inclusion of the novel diagnosis of Compulsive Sexual Behavior Disorder in the forthcoming 11th edition of the International Classification of Diseases has spurred increasing interest in the clinical profile of the disorder. Such attention has included a focus on potential comorbidities, risk factors, or symptoms resulting from such behaviors, including anxiety. Anxiety disorders have long been noted as comorbid with many other diagnoses, such as posttraumatic stress disorder, obsessive compulsive disorder, and substance use disorders. This review aims to understand the relationship between anxiety and compulsive sexual behavior in adults and adolescents, based on available quantitative studies. A search of PsycInfo and PubMed revealed 40 studies which quantitatively assessed a relationship between an anxiety measure and a Compulsive Sexual Behavior Disorder measure, including dissertations and published articles using clinical and community samples. A qualitative synthesis and risk of bias analysis of the studies was conducted, rather than a meta-analysis, due to the variety of methods. Overall, studies were primarily cross-sectional and the relationship between these two constructs was unclear, likely due to several factors, including inconsistent measurement of Compulsive Sexual Behavior Disorder, lack of gender diversity, and very little longitudinal data. Directions for future research are discussed.
... In line with the latter, some studies have found that risky behaviors (e.g., substance use) can predict a decrease in conscientiousness scores (89,90). Further, socioeconomic status is an example of a characteristic that may act as a third variable in the relationship between PG and conscientiousness, as socioeconomic status is known to predict both PG and conscientiousness (91,92). The results further supported H3 (expecting an inverse association between PG and agreeableness), with an overall correlation of −0.163. ...
... Another possible explanation for this finding is that individuals high on openness are considered to be concerned with intellectual processes, and may acknowledge the negative outcomes of gambling, and thus be more likely to avoid gambling compared to those with low scores on openness (12). The association may also in part be explained by socioeconomic status as a third variable, as lower socioeconomic status can predict both PG and lower scores on openness (92,93). ...
Article
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Objectives: The aim of the present meta-analysis was to synthesize results from the association between problem gambling (PG) and dimensions of the five factor model of personality and to identify potential moderators (gambling diagnosis: yes/no, comorbidity: yes/no and trait assessment: four or fewer items vs. five items or more) of these associations in meta-regressions. Methods: Searches were conducted in six databases; Medline, Web of Science, PsychInfo, Google Scholar, OpenGrey, and Cochrane Library (conducted on February, 22, 2021). Included studies: (1) reported a relationship between PG and at least one of the personality traits in the five-factor model, (2) contained information of zero-order correlations or sufficient data for such calculations, and (3) were original articles published in any European language. Case-studies, qualitative studies, and reviews were excluded. All articles were independently screened by two authors. Final agreement was reached through discussion or by consulting a third author. Risk of bias of the included studies was assessed by the Newcastle-Ottawa Scale. Data were synthesized using a random effects model. Results: In total 28 studies, comprising 20,587 participants, were included. The correlations between PG and the traits were as follows: Neuroticism: 0.273 (95% CI = 0.182, 0.358), conscientiousness −0.296 (95% CI = −0.400, −0.185), agreeableness −0.163 (95% CI = −0.223, −0.101), openness −0.219 (95% CI = −0.308, −0.127), and extroversion −0.083 ( 95% CI = −0.120, −0.046). For all meta-analyses the between study heterogeneity was significant. Presence of gambling diagnosis was the only moderator that significantly explained between-study variance showing a more negative correlation to extroversion when participants had a gambling diagnosis compared to when this was not the case. Discussion: The results indicated some publication bias. Correcting for this by a trim-and-fill procedure showed however that the findings were consistent. Clinicians and researchers should be aware of the associations between personality traits and PG. Previous studies have for example showed neuroticism to be related to treatment relapse, low scores on conscientiousness to predict treatment drop-out and agreeableness to reduce risk of treatment drop-out. Systematic Review Registration: PROSPERO (CRD42021237225).
... It has been presented, for example, that several risk factors of gambling harm are more prevalent in the population living in those areas and that gambling may be used as a coping mechanism to deal with stress and poorer quality of life [6,19]. The gambling literature has further shown that rates of gambling and problem gambling are higher among individuals with a lower socioeconomic status [20][21][22]. ...
... There is a strong socio-economic gradient in gambling and its related harm [20][21][22]. People living in disadvantaged areas are more likely to be vulnerable to the adverse consequences of gambling than those living in more affluent areas. ...
Article
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Background: Electronic gambling machines (EGMs) are considered a risky form of gambling. Internationally, studies have reported that the density of EGMs tends to be higher in socioeconomically disadvantaged areas than in more advantaged ones. We examined whether this holds true in the Finnish context where a decentralised system of EGMs guarantees wide accessibility to this form of gambling. More precisely, we investigated the association between the density of EGMs and area-level socio-economic status (SES). Methods: The primary measure was the EGM density, referring to the number of EGMs per 1000 adults. The area-level SES was defined on the basis of the median income of inhabitants, the proportion of unemployment in the area and educational attainment (% of those beyond primary education). Three additional area characteristics were used as control variables in the analyses; the overall population density, economic activity (the number of jobs in the area per employed inhabitant), and the mean age of the inhabitants. Analyses were based on linear regression. Results: The EGM density was 3.68 per 1000 inhabitants (SD = 2.63). A lower area-level SES was correlated with a higher EGM density. In further analyses, this effect was mostly explained by the income of the inhabitants. Of the control variables, the population density had no detectable effect on the EGM density while areas with a higher mean age of the inhabitants, as well a higher density of jobs, had more EGMs. Conclusions: EGMs are unequally located in Finland, with more EGMs located in socio-economically less advantaged areas. The higher machine density in areas of social disadvantage is not in line with the aim of the Finnish gambling policy, which is to prevent and reduce harm caused by gambling. Changes in policy are required, especially with regard to the decisions on the placement of EGMs. This should not be made solely by gaming operators and/or from fiscal perspectives.
... Based on a longitudinal study, Auger et al. [16] showed that individuals with lower SES and impulsivity had earlier age of gambling onset. Van der Maas [17] showed-although among adults-that social setting, which has been downplayed in current problem gambling research, has an important influence on gambling. ...
... Another study showed that overprotection and lower socioeconomic status were related to the risk of excessive internet use. Contradictory findings were also reported regarding SES and substance use among adolescents [14][15][16][17][18][19][20][21][22][23][24][25][26]. The review by Patrick et al. [27] found evidence of a relationship between SES and substance use, although the shape of this relationship varied. ...
Article
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Background and aims: The current level of knowledge concerning the effect of socioeconomic status (SES) on internet use, gambling, and substance use in structurally disadvantaged regions is scarce. The objective of this study was an investigation of the relationship between SES and risky internet use, gambling and substance use in a structurally disadvantaged region in Central Europe. Methods: A cross-sectional survey was conducted among high school students (n = 1063) in a Czech structurally disadvantaged region in autumn 2017. Binary Logistic Regression models were applied to data from the modified Excessive Internet Use scale (mEIUS), a standard tool for measuring the risk of addictive behavior on the internet and the risk of excessive gaming. Other data were collected using the Lie/Bet (problematic gambling), CAGE (acronym of the key words: cut, angry, guilty and eye-opener), and the Cannabis Abuse Screening Test (CAST) (problematic alcohol/cannabis use) tools. Results: There were statistically significant differences between at-risk and not-at-risk groups in addictive behavior on the internet and gaming, while none were found in problematic gambling. Individual dimensions of SES showed significant effects on substance use. Regarding parenting styles, significant differences were found only in the risk of addictive behavior on the internet or gaming between the authoritarian and authoritative styles. Being engaged in behavioral addictions with one´s parents increased the odds of the behavioral addiction risk and decreased the odds of the substance addiction risk. Engagement with one´s parents in substance addictions decreased the odds of the behavioral addiction risk and increased the odds of the substance addiction risk. Discussion and conclusions: The results point at specific relations between SES and the risk of addictive behaviors on the internet and gaming within structurally disadvantaged regions. The results of SES and/or structurally disadvantaged region measures obtained in research, policy-making, and care-provision may improve the focus of actions taken.
... Aiempien kansainvälisten ja suomalaisten tutkimusten perusteella rahapelaamisen ja rahapeliongelman esiintyvyys on korkein sosioekonomisesti heikoimmissa väestöryhmissä: eri maissa esimerkiksi asunnottomien ja työttömyys-tai sairaus avustusta saavien joukossa on todettu esiintyvän enemmän rahapelaamista ja rahapeliongelmia kuin muun väestön keskuudessa (Maas 2016;Layton & Worthington 1999;Lepage & al. 2000;Sharman & al. 2015). Vastaavasti Suomessa on havaittu, että rahapeliongelma on yleisintä työttömillä tai lomautetuilla ja työkyvyttömyyseläkkeellä olevilla sekä pitkäaikaissairailla (Salonen & Raisamo 2015). ...
... Rahapelaamisen yleisyydelle heikommassa sosio ekonomisessa asemassa olevien keskuudessa on etsitty selitystä siitä, että rahapelimahdollisuudet ovat keskittyneet köyhemmille alueille, mutta myös paremman elintason tavoittelusta, mielenterveysongelmien korkeammasta esiintyvyydestä alemmissa sosioekonomisissa ryhmissä, rahapelaamisesta helposti saavutettavana viihteen muotona, selviytymiskeinona vaikeissa tilanteissa tai alakulttuuriin kuulumisen tarpeesta (Blalock & al. 2007;Cavion & al. 2008;Egerer 2014;Maas 2016;Volberg & Wray 2007). Suomalaiset sosiaalijohtajat yhdistävät rahapelaamisen yhteiskunnan taloudelliseen eriarvoisuuteen ja heikommassa asemassa olevien pyrkimyksiin pysyä kulutusyhteiskunnan jäseninä (Heiskanen & Egerer 2018). ...
Article
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Tässä artikkelissa tarkastellaan ensimmäistä kertaa Suomessa rahapeliautomaattien sijoittelua sijoituspaikan sosioekonomisen aseman suhteen. Rahapeliautomaattien on havaittu niin Suomessa kuin muualla maailmassa olevan eniten haittoja aiheuttava rahapelaamisen muoto. Lukuisissa kansainvälisissä tutkimuksissa on havaittu rahapeliautomaatteja olevan suhteessa väestöön kaikkein eniten sosioekonomisesti haavoittuvilla alueilla. Keskeinen muuttuja analyysissa on postinumeroaluekohtainen rahapeliautomaattitiheys 1000 asukasta kohden. Alueen sosioekonomista haavoittuvuutta kuvaavat muuttujat ovat: työttömyysaste, pienituloisten osuus asuinalueen väestöstä ja korkeakoulutettujen osuus väestöstä. Tulosten mukaan alueiden välinen ero rahapeliautomaattitiheydessä on suurin verrattaessa sosioekonomisesti haavoittuvimpia alueita parhaiten menestyviin. Automaatteja on sijoitettuna siis tiheimmin alueille, joissa sosio-ekonomista huono-osaisuutta on eniten. Tulokset antavat aihetta pohtia, olisiko rahapeliautomaattien sijoittelua tarpeen säädellä siten, että vältyttäisiin automaattitarjonnan keskittymiseltä sosioekonomisesti haavoittuville alueille.
... Mental and physical health, including anxiety, mood disorders, post-traumatic stress disorder were identified as some of the most common and consistent risk factor for gambling harm across seven groups of people (van der Maas, 2016, Sharman et al., 2019. While many researchers have identified the drug, alcohol and tobacco use as a risk factor, Sharman et al. noted that existing research has not established if substance abuse leads to gambling, gambling to substance use or whether both substance abuse and gambling come from other underlying conditions (2019). ...
... Research increasingly identifies trauma and adverse life events as a risk factor for or cause of gambling harm (Hodgins et al., 2011, Hodgins et al., 2010, Kausch et al., 2006, Imperatori et al., 2017, van der Maas, 2016, Stone, 2016. 'Pathological' gamblers in treatment programs are more likely to have a history of trauma, often in childhood (Stone, 2016). ...
... A significant relationship between anxiety and addictive behaviors, and technological addictions in particular, has been repeatedly demonstrated (Andreassen et al. 2016;Buckner and Schmidt 2009;Cooper et al. 2014;Essau et al. 2014;Lee and Stapinski 2012;Parhami et al. 2014;Sareen et al. 2006;Van Der Maas 2016). Furthermore, anxiety-related factors such as sensitivity to stress, perceived uncontrollability, and avoidance have also been shown to be associated with addiction severity (Forsyth et al. 2003). ...
... More specifically, results suggested that emergent adult MMO players who reported higher anxiety were inclined to have higher IGD scores. This is in consensus with previous research indicating the role of anxiety as a risk factor for addictions in general (Buckner and Schmidt 2009;Cooper et al. 2014;Parhami et al. 2014;Sareen et al. 2006;Van Der Maas 2016), and for onlinerelated addictive behaviors in particular (Andreassen et al. 2016;Lee and Stapinski 2012). ...
Article
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Understanding risk and protective factors associated with Internet Gaming Disorder (IGD) has been highlighted as a research priority by the American Psychiatric Association, (2013). The present study focused on the potential IGD risk effect of anxiety and the buffering role of family cohesion on this association. A sample of emerging adults all of whom were massively multiplayer online (MMO) gamers (18–29 years) residing in Australia were assessed longitudinally (face-to-face: N = 61, Mage = 23.02 years, SD = 3.43) and cross-sectionally (online: N = 64, Mage = 23.34 years, SD = 3.39). IGD symptoms were assessed using the nine-item Internet Gaming Disorder Scale-Short Form (IGDS-SF9; Pontes & Griffiths Computers in Human Behavior, 45, 137–143. https://doi.org/10.1016/j.chb.2014.12.006, 2015). The Beck Anxiety Inventory (BAI; Beck and Steer, 1990) and the balanced family cohesion scale (BFC; Olson Journal of Marital & Family Therapy, 3(1) 64–80. https://doi.org/10.1111/j.1752-0606.2009.00175.x, 2011) were applied to assess anxiety and BFC levels, respectively. Linear regressions and moderation analyses confirmed that anxiety increased IGD risk and that BFC weakened the anxiety-related IGD risk.
... Introduction Problem gambling (PG) is associated with an array of complex social problems and public health issues [1,2]. For example, PG is associated with multiple measures of poverty, including low income [3][4][5], precarious employment [6,7], and unemployment [4,8,9]. PG is also associated with housing instability and homelessness [10,11]. ...
... The relationship between PG, poverty, and housing instability is a significant and growing public health concern [1,12,13]. Research has documented multiple comorbidities and challenges among people experiencing PG, homelessness, and poverty [3,4], including mental illness, substance use, criminalization, poor coping skills, relationship loss, employment instability, financial insecurity, experiences of discrimination and stigma [2], and histories of trauma [14]. Effective responses to complex co-occurring health and social issues among this population require awareness of the relationship between PG and poverty/homelessness, widespread screening for PG among service agency clients, as well as population-targeted and agency-coordinated PG prevention and recovery services [1,2,11,15]. ...
Article
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The burden of harm from problem gambling weighs heavily on those experiencing poverty and homelessness, yet most problem gambling prevention and treatment services are not designed to address the complex needs and challenges of this population. To redress this service gap, a multi-service agency within a shelter setting in a large urban centre developed and implemented a population-tailored, person-centred, evidence-informed gambling addiction program for its clients. The purpose of this article is to report on qualitative findings from an early evaluation of the program, the first designed to address problem gambling for people experiencing poverty and/or homelessness and delivered within a shelter service agency. Three themes emerged which were related to three program outcome categories. These included increasing awareness of gambling harms and reducing gambling behaviour; reorienting relationships with money; and, seeking, securing, and stabilizing shelter. The data suggest that problem gambling treatment within the context of poverty and homelessness benefits from an approach and setting that meets the unique needs of this community. The introduction of gambling treatment into this multi-service delivery model addressed the complex needs of the service users through integrated and person-centered approaches to care that responded to client needs, fostered therapeutic relationships, reduced experiences of discrimination and stigma, and enhanced recovery. In developing the Gambling Addiction Program, the agency drew on evidence-based approaches to problem gambling treatment and extensive experience working with the target population. Within a short timeframe, the program supported participants in the process of recovery, enhancing their understanding and control of their gambling selves, behaviours, and harms. This project demonstrates that gambling within the context of poverty requires a unique treatment space and approach.
... As such, bus tours are a disproportionately popular way for older adults to access gambling venues. For example, an intercept study of casino gamblers in the American Midwest found that 64.7% of those over the age 65 had come to the casino through an organized bus trip compared to younger cohorts which ranged from 5.1% (21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34) to 17.7% (55-64) 4 . To date, one Australian study has found an association between the perceived importance of shuttle service and problem gambling. ...
... Those over 65 have lower rates of problem gambling compared to younger cohorts 13,24 Despite the proposed benefits of gambling as leisure activity there are several features of older age that can increase the severity of the harm experienced as a result of gambling. Problem gambling has been closely associated with negative emotional states such as depression and anxiety, 25,26 and lower cognitive function 27 . Older age can bring with it a decline in cognitive functions that may make it harder to control one's gambling 28 . ...
Article
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Background and aims: Little research has examined the relationship between incentives used by gambling venues to attract customers and the experience of gambling related harm. Organized and subsidized bus tours are a common example of such incentives. The aim of this study was to examine whether bus tour patronage was associated with increased odds of problem gambling among older adults. This study also compared rates of bus tour use by sociodemographic characteristics and gambling behaviours. Design: Pearson chi square tests and Mann-Whitney U tests were applied for bivariate analyses. Multivariate generalized mixed effects regression modelling was used to examine the relationship between bus tour patronage and problem gambling while controlling for possible confounding factors. Setting: 7 gambling venues located in Central and Southwestern Ontario, Canada. Participants: 1978 gambling venue patrons over the age of 55 MEASUREMENTS: Problem gambling as indicated by the Problem Gambling Severity Index, bus tour patronage in the 12 months prior to the survey, spending per gambling visit, past month slot machine participation. Findings: Regression analyses showed that bus tour patronage was associated with higher odds of problem gambling (OR=1.71, CI=1.06, 2.76) after controlling for several demographic characteristics, type of gambling, and gambling expenditures. Bivariate analyses showed past year bus tour patronage was associated with more frequent slot machine play (x(2) =48.16, p<0.001), more past year gambling venue visits (p<0.001), and lower spending on gambling per casino visit (p<0.001). Compared with non-patrons, bus tour patrons were more likely to be female (x(2) =21.92, p<0.001), born outside of Canada (x(2) =113.18, p<0.001), above the age of 75 (x(2) =24.02, p<0.001), and retired (x(2) =16.60, p<0.001). Conclusions: When adjusting for potential confounders, among older adults, using bus tours to access Canadian gambling venues is associated with increased risk of problem gambling. Bus tour patrons are more likely to be female, born outside of Canada, and above the age of 75.
... On the other hand, parents who are more educated might see gambling as a serious concern related to their adolescents' health and therefore be more eager to supervise their adolescents' gambling than those who are less privileged. It has been shown that low levels of parental monitoring are associated with the risk of getting involved in gambling and developing gambling problems (Spångberg & Svensson, 2020;Vachon et al., 2004). Further, parental approval of gambling is also linked with increased adolescent gambling (Leeman et al., 2014). ...
Article
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Legislation prohibiting minors from engaging in gambling is a gambling policy measure set to protect adolescents from the harmful effects of gambling. The Finnish gambling system is based on a state monopoly, regulated by the Lotteries Act. After an amendment to the Lotteries Act, the new minimum legal gambling age was raised to 18 years old between 2010 and 2011. The main purpose of this study was to discover how the amendment to the act altered adolescents’ gambling (14–16-year-olds) and to examine whether the amendment decreased socio-economic differences. Adolescents gambling was studied before (2008–2009), during (2010–2011), and after (2013–2017) the age limit of gambling was raised in Finland. The study based on five waves (2008–2009, 2010–2011, 2013, 2015, 2017) of the national repeated cross-sectional School Health Promotion Study. Cross-tabulations where gambling was studied by study year and socio-economic status (SES) were formulated, and the statistical differences were studied by using χ²-tests. Percentage change in gambling frequency was also examined by study year and SES. Study years were analyzed separately to model the weekly gambling via logistic regression models. Adolescent gambling significantly decreased over time. It appears that raising the legal gambling age had a permanent effect on under-aged gambling. However, differences in gambling by adolescents’ family’s SES increased during the study period, indicating widening inequalities in gambling among adolescents. Diminishing inequalities in adolescent gambling is likely to require both societal action and consensus on adolescent gambling being a significant social and public health concern.
... The appeal of gambling to those who could be considered financially disadvantaged has been rationalised from a range of theoretical perspectives, including those that focus on societal structures such as social disorganisation and deprivation [60], and the impact of legislative frameworks resulting in social marginalisation and relative powerlessness [61]. Further theoretical perspectives are grounded in the mental health [62], neuropsychological functioning [63] and the economic endeavour [64] of the individual. The appeal of gambling to those experiencing poverty or financial hardship has also been attributed to the psychoeconomics of gambling [65•]. ...
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Purpose of Review The review sought to present research pertaining to gambling and homelessness. Findings mapping the prevalence of disordered gambling within the homeless and those exploring the bi-directional nature of the relationship are discussed. The review explores theoretical explanations for the appeal of gambling to homeless individuals and discusses future directions. Recent Findings Research indicates the prevalence of disordered gambling is significantly higher in the homeless, comparable to the general population. Further research indicates that gambling is more commonly a factor contributing to homelessness, that gambling disorders are often overlooked by homeless services, and that support services are often inadequate. Summary Disordered gambling is common in homelessness; however, the relationship is bi-directional. Gambling can be a direct cause of homelessness, a secondary contributing factor, or only develop after the individual has become homeless. Potential for significant life change is a motivating factor for gambling; for a homeless individual, a small win could be the difference between eating and not eating, or between sleeping in a hostel or on the street. Homeless services can provide a platform for problem identification and direction to the provision of support.
... In addition, the results from our study differ slightly from previous research where low SES repeatedly has been associated with a greater risk of mental health issues in general (Hudson, 2005;Hudson & Roth, 1988;Kivimäki et al., 2020). Specific to gambling, Maas et al. (2016) found that the magnitude of the relationship between anxiety disorders and problem gambling severity varied significantly depending on whether a person were of high or low SES, with the strongest association among the low SES group. Even though the group with high SES had the weakest association also in our study, the association between any anxiety and problem gambling was stronger among the group with middle SES, then in the low SES group. ...
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Co-occurring psychiatric comorbidity is high among problem gamblers, and anxiety disorders has repeatedly been linked to problem gambling. Less conclusive, however, is the association between problem gambling and specific anxiety disorders. The aim of this study is to examine the association between problem gambling and specific anxiety disorders in subgroups of gender, age and socio-economic status (SES) in the general Swedish population. A case-control design was employed - nested in the Swedish longitudinal gambling study cohort. All anxiety disorders studied - Panic Disorder, Social Phobia, Generalized Anxiety Disorder (GAD) and Post-Traumatic Stress Disorder (PTSD), were significantly associated with problem gambling, however the pattern differed across subgroups. Social Phobia was the anxiety disorder most commonly associated with problem gambling across subgroups. The strongest associations between problem gambling and various anxiety disorders were found in participants under the age of 25, among females, and in the group with middle SES. In those groups three of the four anxiety disorders studied were significantly associated with problem gambling, with different patterns. Quite remarkably, participants under the age of 25 had three times higher risk of having had GAD compared to their controls. Efforts to prevent an escalation of either gambling or anxiety could target the presented vulnerable groups specifically.
... Cognitively taxing contexts, such as those characterized by resource scarcity, exacerbate the tendency to react more strongly to the prospect of further losses [63] . Therefore, when presented with the prospect of facing further certain negative events, vulnerable individuals might tend to take riskier decisions, such as in health care [64] and gambling [65] , and these decisions can further worsen the poor conditions in which they live. At the same time, they might forego switching to new convenient tariffs as they fear facing unexpected high bills [66] . ...
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Insufficient access to affordable, safe and reliable energy services deprives individuals of the essential means to live a good, satisfactory and just life. This problem is becoming more and more urgent in urban areas, in particular in low-income neighborhoods, in which the inability to meet energy costs reflects social segregation and distributional inequalities. Making cleaner technologies available for all homes and providing financial aid are strategies that would combat energy poverty. However, understanding people’s everyday decisions that affect their energy use is also crucial. A careful examination of the underlying mechanisms that drive decisions is required, above all in contexts characterized by conditions of scarcity. Living in a context of scarcity depletes people’s available cognitive resources, thus rendering their decisions more susceptible to cognitive biases. As an example, contexts of scarcity trigger a tendency to prefer immediate smaller rewards to delayed larger ones. However, studies demonstrate that this can be mitigated by allowing individuals to build community trust. This study taps into recent findings from behavioral sciences regarding the role that scarcity conditions have on decision-making, with the aim to i) review certain cognitive biases that might arise in energy poverty contexts, and ii) devise strategies to unlock individuals’ potential to make decisions that result in better outcomes for themselves and their surroundings.
... Cognitively taxing contexts, such as those characterized by resource scarcity, exacerbate the tendency to react more strongly to the prospect of further losses [63]. Therefore, when presented with the prospect of facing further certain negative events, vulnerable individuals might tend to take riskier decisions, such as in health care [64] and gambling [65], and these decisions can further worsen the poor conditions in which they live. At the same time, they might forego switching to new convenient tariffs as they fear facing unexpected high bills [66]. ...
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Insufficient access to affordable, safe and reliable energy services deprives individuals of the essential means to live a good, sufficient and just life. This problem is becoming more and more urgent in urban areas, in particular in low-income neighborhoods, in which the inability to meet energy costs reflects social segregation and distributional inequalities. Making cleaner technologies available for all homes and providing financial aid are strategies that would combat energy poverty. However, understanding people’s everyday decisions that affect their energy use is also crucial. A careful examination of the underlying mechanisms that drive decisions is required, above all in contexts characterized by conditions of scarcity. Living in a context of scarcity depletes people’s available cognitive resources, thus rendering their decisions more susceptible to cognitive biases. As an example, contexts of scarcity trigger a tendency to prefer immediate smaller rewards to delayed larger ones. However, studies demonstrate that this can be mitigated by allowing individuals to build community trust. This study taps into recent findings from behavioral sciences regarding the role that scarcity conditions have on decision-making, with the aim to i) review certain cognitive biases that might arise in energy poverty contexts, and ii) devise strategies to unlock individuals’ potential to make decisions that result in better outcomes for themselves and their surroundings.
... Noteworthy, lower SES conditions have been associated with an increased propensity for risk-taking behavior in the real-world [4,14,35,[38][39][40][41]. For example, lower SES has been associated with elevated incidence of substance abuse [42] and behavioral addictions [43]. ...
Article
Lower financial savings among individuals experiencing adverse social determinants of health (SDoH) increases vulnerabilities during times of crisis. SDoH including low socioeconomic status (low-SES) influence cognitive abilities as well as health and life outcomes that may perpetuate poverty and disparities. Despite evidence suggesting a role for financial growth in minimizing SDoH-related disparities and vulnerabilities, neurobiological mechanisms linked with financial behavior remain to be elucidated. As such, we examined the relationships between brain activity during decision-making (DM), laboratory-based task performance, and money savings behavior. Participants (N=24, 14 females) from low-SES households (income<$20,000/year) underwent fMRI scanning while performing the Balloon Analogue Risk Task (BART), a DM paradigm probing risky- and strategic-DM processes. Participants also completed self-report instruments characterizing relevant personality characteristics and then engaged in a community outreach financial program where amount of money saved was tracked over a 6-month period. Regarding BART-related brain activity, we observed expected activity in regions implicated in reward and emotional processing including the amygdala. Regarding brain-behavior relationships, we found that laboratory-based BART performance mediated the impact of amygdala activity on real-world behavior. That is, elevated amygdala activity was linked with BART strategic-DM which, in turn, was linked with more money saved after 6 months. In exploratory analyses, this mediation was moderated by emotion-related personality characteristics such that, only individuals reporting lower alexithymia demonstrated a relationship between amygdala activity and savings. These outcomes suggest that DM-related amygdala activity and/or emotion-related personality characteristics may provide utility as an endophenotypic marker of individual’s financial savings behavior.
... On the other hand, ethnic and cultural diversity is positively associated with higher wages and productivity through its effects on innovation (Hewlett et al. 2013;Ottaviano and Peri 2006;Trax et al. 2015). Thus, with higher wages resulting from cultural and ethnic diversity, the socio-economic gap narrows and financial challenges are less likely to drive people towards gambling, given that gambling is known to be higher among lower socio-economic groups (Brown et al. 1992;Clotfelter and Cook 1999;van der Maas 2016). ...
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Gambling is a popular leisure activity but also a significant public health issue in Australia. The severity of gambling in Australia is characterised by unprecedented gambling expenditures and losses representing the highest gambling rates in the world, which has led to renewed interests in understanding the factors influencing gambling behaviours. We contribute to the debate on the determinants of gambling by providing the first study that examines the impact of ethnic diversity on gambling. Using data from the Household, Income and Labour Dynamics in Australia (HILDA) survey, we find that ethnic diversity is positively associated with gambling. This result is robust to alternative estimation approaches, alternative ways of measuring ethnic diversity and irrespective of whether gambling is measured using the Problem Gambling Severity Index (PGSI), gambling expenditures or number of gambling activities. Our results also suggest stronger effects of ethnic diversity for problem gamblers compared to gamblers in other risk categories. These results support the need for policies that promote social capital in diverse communities to reduce the risks of social isolation, which is an important motivator of gambling behaviour.
... Having said that, there is growing evidence, both nationally [4] and internationally [9], that gambling among women is on the increase. There is also evidence that individuals with lower socioeconomic status are at higher risk of problem gambling [10]. For example, lower income receivers have been found to gamble more than those with a higher income [11]. ...
Article
Aims: This study aims to explore the associations between final compulsory school grades and gambling and their relation to substance use and perceived mental health among people aged 18-29 in Finland (N = 831). Methods: Cross-sectional random sample data, weighted on the basis of age, gender and region of residence, were collected in 2015. The data were analysed using logistic regression models adjusted for sociodemographic variables, risky alcohol use, daily smoking, and perceived mental health. Results: Weekly gambling and at-risk and problem gambling (ARPG) were more common among men. Weekly gambling was linked to smoking and risky alcohol use among men and smoking among women. Additionally, ARPG was linked to risky alcohol use among men. ARPG was associated with moderate/poor mental health among men and women, but this was not the case with weekly gambling. Among men, low and average final school grades at age 16 were associated with weekly gambling later in life, even when adjusting for other variables. Among women, low and average final school grades were not associated with weekly gambling when adjusting for substance use. Lower final school grades were associated with ARPG among women but not among men when all potential confounders were adjusted for. Conclusions: Adolescents with lower final school grades are more likely to gamble weekly later in life. Lower final school grades are also linked with ARPG among women. It is important therefore for schools to have clear policies on gambling and to implement early prevention programmes.
... One prominent correlate of problematic gambling is socio-economic deprivation ( Van der Maas, 2016). Problem gambling is elevated within deprived areas, both in the UK (Carrà et al., 2017), and internationally -with a 'social gradient in gambling and gambling-related harm ' (McMahon et al., 2019, p. 381). ...
Article
The link between gambling and deprivation is well recognized both in the UK and internationally; and manipulating perceptions of relative deprivation can encourage people to gamble. The current study sought to learn more about whether individuals who gamble consciously perceive themselves to be motivated by feelings of deprivation, and how this is contextualized alongside monetary factors more broadly. Thematic analysis was conducted on 25 in-depth qualitative interviews with UK residents who gamble regularly; most of whom resided in areas of high socio-economic deprivation. Monetary themes relating to financial circumstances, the meaning and value of money, and the perception of gambling as a way to make money, all had strong relevance for deprivation, though people did not often endorse the idea that relative deprivation was important to them, per se. We conclude that gambling motivations are complex and heterogeneous, and that it is pertinent for prevention and intervention strategies for problem gambling to consider individuals’ financial circumstances and how they perceive them, along with how this intersects with their gambling motives.
... Specifically, people with anxiety disorders had more severe gambling problems if they had lower socioeconomic status. 32,33 Adolescents who perceive their financial family situation as low are more likely to become risk gamblers than those who perceive it as medium/high. 34 According to a study that investigated problem gambling among a Canadian homeless youth sample, the percentage of youth who exhibited gambling-related risk behavior was 12,6%. ...
Article
Problem gambling emerges as a serious and ever growing problem of modern societies, largely affecting adolescents as well. The etiology of gambling disorder is complex and multifaceted as it is governed by multiple and interrelated factors. In this context and in light of the pervasive financial crisis in Greece, we conducted a study in order to explore adolescents’ gambling involvement in Athens region and also to identify the socio-economic characteristics of adolescents who have engaged into gambling activities. Students were recruited from a sample of schools in Athens area. For the assessment of gambling involvement in adolescents, the Diagnostic and Statistical Manual of Mental Disorders-IV Multiple Response Adapted for Juveniles Questionnaire (DSM-IV-MR-J) was administered. Additional self-constructed questions enquired about students’ socio-demographic and economic characteristics. Our results indicate that adolescents that had problem with gambling or had at least one pathological item on DSM were more likely to be boys and to have been born in a country other than Greece. Additionally, the proportion of those having at least one pathological item on DSM was greater in those with low school grades. Τhe lack of food in the household due to inability of providing food during the last month was significantly associated with both having problem with gambling and having at least one pathological item on DSM. Furthermore, having been worried that there would not be enough food during the last month and having been fed with a restrained variety of food due to lack of recourses were associated with at least one pathological item on DSM. These findings are congruent with the literature suggesting that youth living under poverty often resort to gambling. In conclusion, our results point out the adverse effects of the financial crisis on the development of problem gambling in adolescents within the Greek society. Problem gambling may have developed in response to the ubiquitous insecurity characterizing the Greek society during this rough time period. Interventions should prioritize endowing adolescents with the necessary coping skills for dealing with daily obstacles or life adversities productively and without losing their self-control.
... This point was reflected by an increased tendency of both East and South Asians gamblers to report gambling both online and on land prior to COVID-19 and the intention of approximately 20% of both groups to do so once land-based gambling venues reopened fully. Further investigation is required to assess the influence that low awareness of responsible gambling information and problem gambling services, and the impact of shame and stigma have on gambling-related harms-the latter two factors pertaining to cultural harms, specifically (Ontario Resource Group on Gambling, 2010;Papineau, 2013;Tong et al., 2019). In addition, there is also reasonable grounds to emphasize the need for more research on cultural factors affecting gambling problems and comorbidities that may inform the development of culturally appropriate support resources (Raylu & Oei, 2004;Suissa, 2011). ...
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Online gambling during COVID-19 has been associated with a variety of risk factors and comorbidities, such as co-occurring substance use, mental health problems, and financial concerns and gambling motives. Far less is known about these impacts on ethno-cultural populations, including East and South Asian gamblers. The present study has attempted to explore the health inequities related to these comorbidities and risk factors among East and South Asian gamblers. A cross-sectional online survey of gamblers in Ontario, Canada, was carried out in August 2020—a time when most land-based gambling venues were not operating at full capacity. Descriptive statistical analyses, odds ratios, and negative binomial regression (NBR) were used to compare East and South Asian gamblers to other online gamblers in Ontario. The total survey sample of 2,012 gamblers included sub-samples of East Asian (n = 206) and South Asian gamblers (n = 107). Compared to other gamblers in Ontario, East and South Asians reported higher likelihood of severe gambling problems, risky financially focused gambling motives, gambling under the influence of alcohol, and elevated levels of mental health problems. An adjusted NBR analysis noted that East Asians were more highly involved in online gambling during the pandemic, compared to non-East Asian gamblers. This study has presented an array of factors representing potential health inequities among East and South Asian gamblers during the pandemic. These findings merit further investigation and replication in order to inform the development of appropriate support resources.
... Therefore, the authors tentatively suggest that gambling frequently and/or with large amounts of money may not be a priority when there are other financial responsibilities to prioritise, such as housing and living expenses. While this may explain why the SMM group were less likely to report a high severity of problem gambling, it is inconsistent with the literature on gambling-related harms, which has found that lower socio-economic status is associated with experiencing more harms [75]. A second possible explanation, which is consistent with the gambling literature, is that the higher education levels of the SMM group in this study may have acted as a protective factor [33,76,77]. ...
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Background Sexual minority men (SMM) often experience stressful social environments dominated by stigma and discrimination. SMM are typically more likely than heterosexual men to engage in certain risky behaviours such as problem gambling. This study aimed to compare gambling behaviour among SMM and examine potential risk factors (erroneous gambling cognitions, gambling outcome expectancies, hazardous alcohol use, impulsivity, and psychological distress; as well as perceived stigma and discrimination for the SMM participants) and potential protective factors (resilience, social support, and community connectedness) for problem gambling severity and gambling-related harms among SMM living in Australia. Methods An online survey, with an over-representation of SMM participants and problem, moderate-risk, and low-risk gamblers, was completed by 101 SMM (mean age = 28.5) and 207 heterosexual men (mean age = 26.4). Results SMM were found to have significantly lower levels of problem gambling severity compared with heterosexual men, and report significantly lower gambling participation, frequencies and expenditure on any gambling activity, casino table games, horse racing/greyhound betting, sports betting, and keno. However, in the SMM group, 38.3% were classified in the problem gambling category of the Problem Gambling Severity Index and 27.6% were classified in the moderate-risk gambling category. There were no significant differences between groups in gambling-related harms. Multiple regression analyses revealed that problem gambling severity and related harms were independently predicted by higher levels of impulsivity and erroneous gambling cognitions for both groups. Conclusions Lower frequency of gambling behaviours among SMM and similar risk factors predicting problem gambling severity/harms for both groups suggests that problem gambling is not pronounced among SMM. This study adds new evidence to the gambling literature which can be used as comparative benchmarks for future research.
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Problematic online betting among adolescents has attracted considerable public attention internationally for the last two decades. Although the online betting prevalence rate in Turkey is unclear, some reports indicate that it could be more pervasive than is currently estimated. The aim of this study was to determine the prevalence of problematic online betting, common behaviors of youth related to betting, and to identify the effect of family on online betting among Turkish adolescents. We surveyed 6116 adolescents aged between 12 and 18 in Istanbul to determine if they are problematic Internet users for betting. Although 756 (12.4%) adolescents reported that they play online betting, only 176 adolescents (2.9%) were classified as problematic Internet users. Thus, we collected further data from those 176 adolescents, 14.8% of which were female. A significant positive correlation was found between Internet Addiction (IA) and duration of betting. Almost 61% of participants expressed that they prefer to be online because they do not have better things to do. Almost a quarter of the participants started online betting between 10 and 12 years of age. All participants know someone who bets online. In terms of frequency, these are friends, relatives, siblings, and parents, respectively. Although there is no relationship between family structure and IA among adolescents who are problematic users, participants who live in an unstable family have higher IA scores than participants who live in a stable family.
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This review focuses on the issue of poverty affecting economic decision-making. By critically evaluating existing studies, the authors propose a structural model detailing the cognitive mechanism involved in how poverty negatively impacts economic decision-making, and explores evidence supporting the basis for the formation of this model. The suggested mechanism consists of a relationship between poverty and four other factors: (1) cognitive load (e.g., experiencing negative affect and stress); (2) executive functions (e.g., attention, working memory, and self-control); (3) intuition/deliberation in decision-making; and (4) economic decision-making (e.g., time-discounting and risk preference), with a final addition of financial literacy as a covariate. This paper focuses on shortfalls in published research, and delves further into the proposed model.
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An exclusion system for gambling arcades has been introduced recently in the state of Hesse. The aim of this paper is to identify significant predictors that are useful in explaining the variation of exclusions between different Hessian communities. Next to socio-demographic factors, we control for three different accessibility variables in two models: the number of electronic gambling machines (EGMs) in model I, and the number of locations and density of gambling machines at a location in model II. We disentangle the association between EGMs and exclusions of model I into a location and a clustering effect. Considering the socio-demographic variables, the explanatory power of our cross-sectional models is rather low. Only the age group of the 30–39 years old and those who are not in a partnership (in model I) yield significant results. As self-exclusion systems reduce availability for the group of vulnerable players, this analysis provides evidence for the assumption that the two groups—pathological gamblers and vulnerable players—seem to have little overlap concerning sociodemographic characteristics. The accessibility variables, on the other hand, turn out to be significantly associated with the number of exclusions. All three of them are statistically significant and their association is positive. The results of model II show that the location effect is more pronounced then the clustering effect of EGMs, i.e. the effect of an additional single-licensed arcade on the number of exclusions is stronger than the increase in the number of license at one location.
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In comparison to jurisdictions, such as Australia, limited research has focused upon the perceptions and reported effects of gambling advertising within the unique gambling environment of the UK. An online qualitative survey was conducted with 62 young adult gamblers in the UK. The survey investigated the place, meaning and influence of gambling advertising within the lives of the participants.Demographic data were analyzed using descriptive statistics, with qualitative data interpreted using inductive thematic analysis techniques. Three themes were identified. Firstly, young adults were highly cognizant of UK gambling advertising strategies. Second, young adults were able to describe the influence of gambling advertising including its normalizing effect and proliferation of misleading messages. Finally, young adults perceived that current harm minimization strategies, including responsible gambling messages, were ineffective. Many were supportive of increased regulation of gambling advertising. The findings indicate that young adults are aware of the potential risks associated with gambling advertising and are supportive of regulatory reform. It is important that the views and perspectives of young adults are fully considered by regulators and policy makers in the UK, particularly as they are a potential target demographic for the industry.
Article
Background: Gambling is a behaviour engaged in by millions of people worldwide; for some, gambling can become a severely maladaptive behaviour, and previous research has identified a wide range of psychosocial risk factors that can be considered important for the development and maintenance of disordered gambling. Although risk factors have been identified, the homogeneity of risk factors across specific groups thought to be vulnerable to disordered gambling is to date, unexplored. Methods: To address this, the current review sought to conduct a systematic overview of literature relating to seven vulnerable groups: young people and adolescents, older adults, women, veterans, indigenous peoples, prisoners, and low socio-economic/income groups. Results: Multiple risk factors associated with disordered gambling were identified; some appeared consistently across most groups, including being male, co-morbid mental and physical health conditions, substance use disorders, accessibility and availability of gambling, form and mode of gambling, and experience of trauma. Further risk factors were identified that were specific to each vulnerable group. Conclusion: Within the general population, certain groups are more vulnerable to disordered gambling. Although some risk factors are consistent across groups, some risk factors appear to be group specific. It is clear that there is no homogenous pathway in to disordered gambling, and that social, developmental, environmental and demographic characteristics can all interact to influence an individual's relationship with gambling.
Thesis
As a superordinate topic, the thesis analyzes and evaluates selected pre-commitment tools that are available in the German gambling context. Pre-commitment is a form of self-binding that allows gamblers to limit money and time spent on gambling before they start a session. This is based on the underlying idea that gamblers will benefit from the fact that expenses and duration of stay are determined before commencing a gambling session, when they are not yet in a state of emotional arousal and hence more capable of deciding rationally. The most extreme form of limitation is the exclusion from gambling. While other countries established formalized pre-commitment systems allowing gamblers in arcades to limit time and money spent on gambling and/or self-exclude from establishments, Germany has not established such a comprehensive scheme yet. There are, however, certain types of gambling, for which at least exclusions are regulated, enforced and externally binding. To further improve the exclusion schemes, it is important to understand the drivers of exclusions. Hence, the second and third chapter of this thesis analyze the drivers for the variation of the number of exclusions between municipalities. Next to sociodemographic characteristics, the models also contain availability measures. Other than most countries, Germany distinguishes between casinos and gambling arcades. Casinos offer table games as well as automated gambling, whereas gambling arcades only provide electronic gambling machines (EGMs hereafter). Both establishments naturally attract different clientele, hence, a thorough examination of these two different types of gamblers is important. Chapter two concentrates on analyzing which variables drive the differences in the number of exclusions from casinos throughout German municipalities. This chapter aims to analyze the degree to which sociodemographic factors and proximity measures can be used to explain the variation in the number of excluded gamblers across German communities. At the time of the analysis, the exclusion file consisted of 31,118 unambiguously assignable entries distributed among 3,091 communities. The results of the study suggest that excluders are more likely to be male, between 30 and 39 years old, and less likely to be single. As only few of the sociodemographic variables yield significant results, we can only partially confirm the well-established risk factors for problematic or pathological gambling. Additionally, the results show that the number of exclusions increases with close proximity to gambling establishments. The distance to the closest casino has a negative impact on exclusions. This is backed up by the finding indicating that in relation, there are more exclusions in communities where casinos are located directly. Chapter three deals with a similar research question, which this time is tailored to excluders from gambling arcades in Hesse, Germany. The aim of the paper is to identify significant predictors that are useful in explaining the variation of exclusions between different Hessian communities. This data set contains 11,902 exclusions that are distributed among 191 Hessian communities. Next to sociodemographic factors, we control for three different accessibility measures in two models: the number of electronic gambling machines in model I as well as the number of locations and density of gambling machines at a location in model II. Considering the sociodemographic variables, the explanatory power of the cross-sectional models is rather low. Only the age group of 30 to39-year-olds and those who are not in a partnership (in model I) yield significant results. Hence we are again not able to determine a specific sociodemographic background for self-excluders. The accessibility variables, on the other hand, turn out to be significantly associated with the number of exclusions. All three of them are statistically significant and their association is positive. The fourth chapter deals with self-limitation, which is another type of pre-commitment. As there has existed no formalized limit scheme in Germany, it is left to evaluate voluntary and self-initiated limits that are frequently used as self-management strategies by gamblers, independent of their gambling severity. The analysis yields promising results. 50 percent of gamblers use at least one limit. There are significant differences in most variables concerning gambling behavior. Gamblers with limits consistently spend significantly less time and money in gambling arcades. The overarching goal of this doctoral thesis is to provide insights considering pre-commitment tools that can be used in the German gambling context. It shows that pre-commitment is an accepted and widely used instrument with positive consequences for gamblers. It is therefore worthwhile in any case to further expand the existing programmes.
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The goal of the present systematic review is to identify emerging gambling problems and the harm minimization strategies proposed to address them. Our interdisciplinary research team conducted this systematic literature review in 5 nations between which there is significant gambling research exchange. A keyword search of the Scopus and Web of Science databases followed by filtering using inclusion criteria identified 1292 empirical gambling studies from peer-reviewed journals. The data obtained from the articles were analyzed using the content analysis technique. We then used a unique approach to identify relationships between harm minimization strategies and gambling problems. The findings reveal that the most frequently reported gambling problems are related to young gamblers, online gambling, electronic gaming machines, and children and adolescents (underage gamblers). Harm minimization strategies to address these included creating educational and awareness programs, further restrictions on gambling advertising, developing an intervention mechanism for online gambling, and remote gambling-related help (i.e., online counseling, online treatment).
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The burden of gambling problems is felt more strongly among people who experience poverty. A small but emerging body of research is developing with no identified reviews exploring the scope of the academic literature on the confluence of poverty and gambling problems. The Arksey and O’Malley scoping study framework was used to map research on this multifaceted topic. We synthesized findings of 27 studies, spanning several national contexts on prevalence of problem gambling and associations of it with poverty. Findings indicated that gambling problems were associated with several poverty measures including employment/unemployment, housing instability, homelessness, low income, and neighborhood disadvantage. The complex interplay of gambling problems with social and health issues emerged in qualitative papers. Relatively few studies explored the connection between poverty and gambling problems despite higher prevalence of gambling problems in this population. Those experiencing both concerns face myriad challenges necessitating surveillance and treatment within vulnerable populations. Further research should explore pathways to gambling problems and poverty and also the associative nature and temporal sequencing of the two phenomena. Global awareness on the topic from a research and clinical/community service perspective is necessary.
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This study presents a large-scale mapping review of how the literature on gambling identifies suggested solutions to prevent or reduce gambling harm and whose responsibility it is to implement them. The purpose of this is to provide a concise reference for stakeholders who must make critical decisions regarding the enhancement of consumer protection and harm minimization measures. Two databases, Scopus and Web of Science, were searched to identify relevant studies. The initial search yielded 5135 results, from which a total of 1292 empirical studies published between 2014 and 2018 were selected for analysis. Inductive content analysis was performed to identify suggested solutions reported in each study. The results indicate that commonly suggested solutions are the creation of educational and awareness programs (e.g., information on the risks of gambling, resources for help seekers, how games really work) and further restrictions on gambling advertising. We found that health service providers are mostly given the responsibility to implement various strategies, followed by policy makers. Numerous empirically proven suggestions for health service providers, policy makers, gambling industry operators, educational institutions, consumers, and families are discussed in detail.
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The association between problem gambling and suicidal behaviours is well established in treatment seeking populations, but less explored among sub-clinical problem gamblers in the general population. The aim of this study was to examine the association between problem gambling (including moderate risk gambling) and suicidal ideations/suicide attempts, in the general Swedish population. Another aim was to compare problem gamblers with and without suicide ideation/attempts. A case-control study nested in the Swelogs cohort was used. Both ideations and attempts were about twice as frequent among the cases compared to the controls. After controlling for socio-economic status and life-time mental health problems, suicidal ideation, but not attempts, remained significantly higher among the cases compared to the controls. The largest difference between attempters and non-attempters were on payment defaults and illicit drug abuse, whereas depression yielded the largest difference between ideators and non-ideators. Problem gambling severity (PGSI 8+) resulted in the smallest difference, compared to the other variables, between attempters and non-attempters. Even though no conclusion regarding the casual relationship can be drawn in this type of study, it seems like sub-clinical levels of problem gambling might have an impact on suicidal ideations whereas for suicide attempts to occur, other factors need to be present. In addition to mental health issues, financial difficulties may be such factors.
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A small body of research has shown that gambling problems are elevated among homeless populations and suggests the complexity of relationships between homeless-ness, gambling and a broad range of other social and addiction issues. This research explored patterns of gambling and coexisting issues at the level of the individuals' experiences. We describe the experiences of 17 residents of a transitional housing service who had experienced gambling harm as people who gamble and/or affected others, using a descriptive qualitative approach. Four themes, each with subthemes, were identified in the data. Participants described their histories, strong links between methamphetamine use and gambling and the importance of connectedness and family to recovery. Gambling was seldom an issue raised by professional services or divulged by the participants, nor was it described as a key factor in becoming homeless. General self-help strategies (such as distraction) were adapted by participants in attempts to modify or control their gambling. The present results stress the need to destigmatise gambling problems (even relative to methamphetamine use) and to provide gambling information and support through a broad range of social and health services in a way that resonates both with those affected those providing professional support.
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A disproportionate amount of research on impulsivity has focused on trait-related aspects rather than state fluctuations. As a result, the relationship between state impulsivity and moment-to-moment behaviour is unclear. Impulsivity is assumed to negatively affect self-control, but an alternative explanation, yet to be tested, could be that changes in state impulsivity and its homeostatic drivers influence the intensity of urges. We tested whether state impulsivity and hunger affected behaviour through a dual-process model, affecting both the experience of various urges, and self-control, using a smartphone-based experience sampling approach. We found that state impulsivity is associated with stronger urges, but we found no evidence of an association with diminished self-control. Being hungry amplifies urges across different types of urges, and both hunger and late hours are negatively related to the likelihood of controlling urges. These findings imply that the influence of hunger is not limited to the food domain, and provide new insight into the role of state impulsivity in daily life.
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This book documents the history of ideas about problem gambling and its link to addictive disorders. The book uses a combination of literature review and conceptual and linguistic analysis to explore the way ideas about problem gambling gave changed over time. It examines the religious, socio-cultural, and medical influences on the development of the concept of problem gambling as a disease, along with the ways in which such ideas were influenced by attitudes about substance abuse. The history of mental illness, notably as it pertains to themes such as loss of control over behavior, is also addressed. The book ends with a discussion of the current status and future prospects, with an eye to which ideas about problem gambling and addictions seem most promising and which should perhaps be left behind. © Springer Science+Business Media New York 2013. All rights are reserved.
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This essay examines the major conceptual issues concerning medicalization and social control, emphasizing studies published on the topic since 1980. Several issues are considered: the emergence, definition, contexts, process, degree, range, consequences, critiques, and future of medicalization and demedicalization. Also discussed are the relation of medicalization and social control, the effect of changes in the medical profession and organization on medicalization, and dilemmas and lacunae in medicalization research.
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Electronic gambling machines (EGMs) are ubiquitous in social venues such as hotels and clubs in most Australian states, and account for 55% of total gambling expenditure in Australia; they are also associated with most gambling derived harm. Because of the difficulty of assessing the prevalence of problem gambling and the incidence of gambling derived harms, gambling expenditure (i.e., the losses of those gambling) is often used in gambling research as a proxy indicator of harm. This study examines the relationship between socioeconomic disadvantage (measured by the Australian Bureau of Statistics SEIFA Index of Relative Socioeconomic Disadvantage [IRSD]), and EGM losses at the suburban level across a major Australian city. It develops a predictive spatial model of gambling vulnerability and presents the output visually. The findings reveal increasing levels of loss as disadvantage increases across IRSD quintiles. The highest mean annual EGM losses of $849 per adult (95% CI $AU749-963) occurred in areas classified in IRSD Quintile 1, the most disadvantaged areas; in the least disadvantaged areas, mean annual losses were $298 per adult (CI $260-$342). The density of EGMs confounds the relationship between losses and disadvantage. In this model, 40% of the apparent effect of disadvantage is explained by the density of EGMs. The vulnerability surface reflects socioeconomic patterns across Melbourne. EGM vulnerability is clustered (Moran's Index 0.52; p < 0.001). High levels of EGM density in disadvantaged areas are contributing to a disproportionate share of EGM losses in already disadvantaged neighbourhoods. Regulation of EGMs could be improved to better protect vulnerable neighbourhoods from EGM harm.
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Sociodemographic features, phenomenology, and psychiatric comorbidity of 30 subjects reporting pathological gambling behavior were examined. Twenty-three men and seven women were recruited by advertisement and word-of-mouth. They all scored higher than 5 points on the South Oaks Gambling Screen, indicating problematic gambling behaviors. They completed structured and semistructured assessments, including the Diagnostic Interview Schedule for DSM-III-R disorders (DIS), the Personality Diagnostic Questionnaire, Fourth Revision (PDQ-IV), and the Minnesota Impulsive Disorders Interview. The typical subject was a 44-year-old white married man with a mean income of $34,250 who visited a casino once or more weekly. All 30 subjects reported gambling more money than they intended to. Twenty subjects (67 percent) reported gambling as a current problem, and nine (30 percent) reported it as a past problem. Twenty-one subjects (70 percent) wanted to stop gambling but did not feel they could. According to DIS results, 18 subjects (60 percent) had a lifetime mood disorder, 19 (64 percent) a lifetime substance use disorder, and 12 (40 percent) a lifetime anxiety disorder. Based on the PDQ-IV, 26 subjects (87 percent) had a personality disorder, the most common being obsessive-compulsive, avoidant, schizotypal, and paranoid personality disorders. The sample also had a relatively high rate of antisocial personality disorder. Impulse control disorders were common, especially compulsive buying and compulsive sexual behavior. The results confirm that individuals with pathological gambling suffer substantial psychiatric comorbidity. They support continued inclusion of pathological gambling in the diagnostic category of impulse control disorders.
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At the moment, there is no single conceptual theoretical model of gambling that adequately accounts for the multiple biological, psychological and ecological variables contributing to the development of pathological gambling. Advances in this area are hampered by imprecise definitions of pathological gambling, failure to distinguish between gambling problems and problem gamblers and a tendency to assume that pathological gamblers form one, homogeneous population with similar psychological principles applying equally to all members of the class. The purpose of this paper is to advance a pathways model that integrates the complex array of biological, personality, developmental, cognitive, learning theory and ecological determinants of problem and pathological gambling. It is proposed that three distinct subgroups of gamblers manifesting impaired control over their behaviour can be identified. These groups include (a) behaviourally conditioned problem gamblers, (b) emotionally vulnerable problem gamblers and (c) antisocial, impulsivist problem gamblers. The implications for clinical management are discussed.
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Low socioeconomic status (SES) is generally associated with high psychiatric morbidity, more disability, and poorer access to health care. Among psychiatric disorders, depression exhibits a more controversial association with SES. The authors carried out a meta-analysis to evaluate the magnitude, shape, and modifiers of such an association. The search found 51 prevalence studies, five incidence studies, and four persistence studies meeting the criteria. A random effects model was applied to the odds ratio of the lowest SES group compared with the highest, and meta-regression was used to assess the dose-response relation and the influence of covariates. Results indicated that low-SES individuals had higher odds of being depressed (odds ratio = 1.81, p < 0.001), but the odds of a new episode (odds ratio = 1.24, p = 0.004) were lower than the odds of persisting depression (odds ratio = 2.06, p < 0.001). A dose-response relation was observed for education and income. Socioeconomic inequality in depression is heterogeneous and varies according to the way psychiatric disorder is measured, to the definition and measurement of SES, and to contextual features such as region and time. Nonetheless, the authors found compelling evidence for socioeconomic inequality in depression. Strategies for tackling inequality in depression are needed, especially in relation to the course of the disorder.
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Gamblers and gambling have been variously viewed as derelict, immoral or criminal. Since the mid-1960s, notions of gambling generally and excessive gambling specifically have been reconstructed. Gambling, if done in moderation, is today generally viewed as an acceptable form of leisure. Those who gamble to the extent that relationships, family, friends, physical, social and mental heath, employment, or finances are adversely affected are now regarded as having a problem and offered government-sponsored therapeutic intervention. Recent developments in this transformative process have witnessed the emergence of coalitions of seemingly disparate interest seeking to promote responsible gambling. Our discussion charts these changing conceptions of gambling.
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The current study examined the effect of neighborhood disadvantage and gambling availability on gambling participation and pathology. A national telephone survey included 2631 US adults. Census data was used to characterize the respondent's neighborhood, and the distance from the respondent's home to gambling facilities was calculated. Logistic and linear regressions were performed to predict gambling participation and pathology. Results showed that the neighborhood disadvantage was positively related to frequency of gambling and problem/pathological gambling. The presence of a casino within 10 miles of the respondent's home was positively related to problem/pathological gambling. The permissiveness of gambling laws was positively related to any gambling in the past year, as well as frequent gambling. These results were interpreted to mean that the ecology of disadvantaged neighborhoods promotes gambling pathology, and that availability of gambling opportunities promotes gambling participation and pathology.
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This study aims to analyze alcohol consumption patterns throughout a week, controlled by socio-demographic characteristics, and to discuss the adequacy of the complex models employed. The sample included 496 participants, from both sexes, > or =40 years old and with 7-day dietary records. Bayesian generalized additive mixed models (GAMM) were applied using two approaches: a multinomial model, with three categories of alcohol consumption behaviour including; non-drinkers, alcohol during meals only and alcohol at any time; and a gamma model for drinkers which considered the total amount of alcohol ingested per day. The multinomial model captured two different patterns of alcohol consumption: a sharp increase in consumption on weekends for mealtime only drinkers, the dominant behaviour among drinkers and a linear increase from Monday towards Sunday for those who drank at anytime. The effect of higher education changed from slightly protective for mealtime only drinkers to risky for anytime drinkers. The amount of alcohol consumed presents a pattern similar to the meals-only drinking. Alcohol consumption increased during the week. Two different alcohol consumption patterns were identified according to drinking behaviours. The methodological approach utilized was essential in uncovering these patterns.
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While there is increasing evidence of an association between poor mental health and the experience of poverty and deprivation, the relationship is complex. We discuss the epidemiological data on mental illness among the different socio-economic groups, look at the cause -effect debate on poverty and mental illness and the nature of mental distress and disorders related to poverty. Issues related to individual versus area-based poverty, relative poverty and the impact of poverty on woman's and child mental health are presented. This review also addresses factors associated with poverty and the difficulties in the measurement of mental health and illness and levels/impact of poverty.
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State lotteries as they are operated in the United State today involve four distinct aspects: legalization of lottery games, monopolistic provision by the state, marketing of lottery products, and extraction of a portion of the surplus they derive from sales for state revenue. In this paper we use conventional tools of applied public finance to examine the implicit tax levied by lottery agencies through this fourth function . We examine the incidence of the implicit lottery tax, focusing on the dominant lottery games used in the 1980s. We find that the implicit tax is regressive in virtually all cases. We then consider whether the implicit tax rate on lotteries is too high, comparing that rate to excise tax rates on alcohol and tobacco.
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This essay examines the impact of "new public management" on the Canadian public service. It argues that, without much public debate, the principles by which the public service operates changed dramatically in the 1980s and 1990s. New public management is a complex set of ideas about the political, economic and organizational bases of modem society. It prescribes flexible organizations that seek business efficiency and greater responsiveness to citizen interests, and assumes that government services need not be delivered by governments themselves. It envisions a "partnership" society. New public management has been adopted by Canadian governments as they struggle to balance their budgets; however, its application has redefined government accountability and raised questions about the capacity of governments to deliver services in the third millennium. More robust finances are no panacea for Canada's public services. The impact of e-government, restaffing and debate about the role of government will generate demands for continuing administrative reform.
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Aims: The aim of this paper is to provide an overview of the development and current status of gambling and gambling policy in Norway. Methods: An overview of the research literature and official documents and websites. Results: Gambling on electronic gaming machines (EGMs) increased dramatically in the 1990s in response to technological development and liberalization of gambling policy. Restrictions on availability of EGM gambling occurred from 2006 to 2009 and included a ban on note acceptors, a temporary ban on EGMs and re-introduction of fewer and less aggressive machines under a state monopoly. The restrictions led to significant decreases in total gambling turnover, and several studies suggest that they led to fewer gambling and gambling problems. Various factors may explain why the restrictions were politically feasible. These include media coverage of gambling concerns and economic compensation for revenue losses under the monopoly. Conclusions: In an international context of deregulation of gambling markets, the Norwegian policy restrictions on gambling availability have represented an exceptional case and provide a rare opportunity to explore the outcomes of such regulations. Overall, studies suggest that the policy restrictions have led to reductions in gambling expenditures and problem gambling.
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There are few published studies on the comorbidity of psychosis and problem gambling. This paper provides estimates of the prevalence and clinical correlates of problem gambling in a representative sample of people with psychotic disorders. The second Australian national survey of psychosis was undertaken in 2010 and included adults (18-64years) attending mental health services. Problem gambling was measured using the Canadian Problem Gambling Index (CPGI) at two sites of this study, with 442 participants providing data suitable for analysis. There were 151 participants who screened positive to past-year gambling. 4.1% of the total sample was classified as low risk gamblers, 6.4% were moderate risk gamblers and 5.8% were problem gamblers. Moderate risk/problem gamblers were more likely to be male, have left school with no qualifications and have sought financial assistance in the last year. There was a significant association with substance use, including alcohol use disorders and use of cannabis and 'other' drugs (excluding cannabis). People with psychosis are four times more likely to have a gambling problem than the general population. The association of gambling with substance use disorders is consistent with community studies, while the increased need for financial assistance suggests that problem gambling increases the likelihood of financial harm for this population. Clinicians should screen for comorbid gambling problems in people with psychosis, while there is also a need for additional research into this area. Copyright © 2015 Elsevier Inc. All rights reserved.
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Purpose – This paper, which builds on the findings of WHO's Report on Mental Health and Development, aims to highlight the health, social, economic, and human rights effects of unaddressed mental disorders in low and middle income countries (LMICs) and to propose effective strategies to address mental disorders and their impacts as part of an overall development strategy. Design/methodology/approach – The paper first reviews the findings of relevant research on mental disorders and poverty and then proposes solutions that can be adopted by countries to promote development. Findings – This evidence of strong links between poverty and mental disorder supports the argument that mental disorders should be an important concern for development strategies. Mental disorders have diverse and far-reaching social impacts, including homelessness, higher rates of imprisonment, poor educational opportunities and outcomes, lack of employment and reduced income. Targeted poverty alleviation programmes are needed to break the cycle between mental illness and poverty. These must include measures specifically addressing the needs of people with mental health conditions, such as the provision of accessible and effective services and support, facilitation of education, employment opportunities and housing, and enforcement of human rights protection. Originality/value – The paper highlights that four out of every five people suffering from mental disorders are living in LMICs. Many LMICs have identified mental health as an important issue, yet lack the finances and technical expertise to address the problem. Having mental health on the agenda of development organizations will be a critical step for overcoming the negative development consequences of mental disorders.
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The importance of coping skill enhancement in the treatment of pathological gamblers is discussed. It is particularly critical to assess and enhance the coping skills of relapse prone gamblers who are marked by unusual degrees of impulsivity, high levels of negative affect and feelings of helplessness and hopelessness. A study of 1129 substance abusers, including 140 with serious gambling problems is reported. All were assessed to determine their repertoire of coping skills. The patients with serious gambling problems utilized significantly more avoidant and impulsive coping styles.
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This article contends that youth gambling is a formidable social problem that draws on those who can least afford it, is partly derived from a general disempowerment from society, and as a consequence, is connected with risk-taking behaviors such as drug and alcohol abuse. To explore further the complex nature of youth gambling and its relation to social disadvantage, the empirical analysis incorporates comparisons between Aboriginal and non-Aboriginal youth and between male and female youth. The conclusions suggest that youth gambling is a form of regressive taxation that exploits those who are most vulnerable because of their socioeconomic marginality and their feelings of relative powerlessness.
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This study tested whether problem gambling and substance use in adolescents are related and whether they could have a common link with impulsivity. A community sample of 765 adolescents participated. Gambling and substance use were assessed when adolescents were 17 yrs old. Impulsivity and impulsivity-related behaviors were assessed when adolescents were 12, 13, and 14 yrs old. Groups of gamblers and groups of substance users were formed, A comorbid group was also formed. Results indicated that problem gamblers were more at risk of also being problem substance users and vice versa than nonproblem participants. In addition, comorbid participants were more impulsive than problem gamblers only or problem substance users only. These findings are discussed in light of the possibility that problem gambling and substance use develop simultaneously during adolescence and share a common impulse-control deficits origin. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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Investigated the relationship between socioeconomic status (SES) and psychiatric disorder based on community interviews with 3,000–5,000 household residents and 400–500 institution residents (Ss were 18 yrs or older) from each of the 5 sites of the Epidemiologic Catchment Area Program (D. A. Regier et al; see PA, Vol 73:1361). Psychiatric disorder was assessed using the Diagnostic Interview Schedule which elicits Diagnostic and Statistical Manual of Mental Disorders (DSM-III) diagnoses. Specific disorders assessed include major depression, alcohol abuse or dependence, cognitive impairment, and schizophrenia. Previous findings of the highest rates of disorder occurring in the lowest SES groups are generally confirmed. The SES relationship varied among disorders, with the strongest relationships occurring for cognitive impairment and schizophrenia. The SES relationship was intermediate for alcohol abuse or dependence and was weakest, but still significant, for major depression. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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Since the early 1970s, income inequality in the United States has increased dramatically. We examine the impact of gambling on income inequality in the American states from 1976 to 1995. Using state-level data over time to evaluate the effects of various types of legalized gambling, from slot machine parlors to lotteries, we find clear evidence that lotteries foster inequality but no evidence of a similar effect for other types of gambling. These results suggest that the increasing prevalence of various forms of nonlottery gambling will have little effect on income inequality.
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It is argued that the analytical comparison of gambling regulatory frameworks across jurisdictions requires the identification of salient dimensions to provide the basis for such. It is further suggested that governmental ‘conflict of interest’ might provide a useful dimension for such comparison, as operationalised by concomitant EGM harm and government dependence criteria. The same ‘conflict of interest’ criteria are then suggested as a guide for gambling regulation within single jurisdictions, this being named the ‘Public Accountability Approach.’ These points are discussed within broader reference to lines and webs of harm production within a public health analysis. Broader reference is also made to the proper role of government within contemporary democracy.
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The harms associated with the proliferation of gambling opportunities is increasingly being researched and documented as part of a public health approach to reduce gambling related harm in many countries. New Zealand has had a history of gambling for just under 200years with the behaviour introduced by new settlers to New Zealand and the indigenous population around 1840. This paper proposes that gambling contributes to the social disorganisation and social deprivation of many communities and especially, those which are low income and are the residence of indigenous and ethnic minority populations. New Zealand has adopted a public health approach to addressing gambling related harm and this is supported through legislation. As part of a public health approach to reduce gambling related harm new questions are proposed to challenge those who have power in the licensing and regulation of gambling and the authority as where public health resources should be directed to remove gambling related harm. Maori the indigenous population of New Zealand is the focus this paper, but the questions proposed can be used by different groups in communities where gambling creates harm.
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To date, a method for the cost-effective prediction of venue catchments, and hence the spatial distribution of EGM harm, has not been available at the local level. As a first step in developing such a method, we explore the utility of a gravity modeling approach to predict the spatial distribution of venue catchments in a metropolitan region of the Northern Territory, Australia. Key inputs for the model presented include existing venue and recently released ABS Mesh Block data. We subsequently perform a combinatory analysis that integrates the predicted venue catchments with an Australian Bureau of Statistics (ABS) measure of social disadvantage to generate a gambling vulnerability surface. The advantages of this approach are that it allows visualization of catchments for effective communication, is based upon existing and current data that is available publicly through the ABS making it cost-effective, and provides a fine-grained local-level assessment of gambling vulnerability for applied policy purposes.
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Pathological gambling (PG) frequently co-occurs with anxiety disorders. However, the extent to which the co-occurrence is related to genetic or environmental factors across PG and anxiety disorders is not known. Data from the Vietnam Era Twin Registry (n=7869, male twins) were examined in bivariate models to estimate genetic and shared and unique environmental contributions to PG and generalized anxiety disorder (GAD) and PG and panic disorder (PD). While both genetic and unique environmental factors contributed individually to PG, GAD, and PD, the best fitting model indicated that the relationship between PG and GAD was attributable predominantly to shared genetic contributions (r(A)=0.53). In contrast, substantial correlations were observed between both the genetic (r(A)=0.34) and unique environmental (r(E)=0.31) contributions to PG and PD. Results may be limited to middle aged males. The existence of shared genetic contributions between PG and both GAD and PD suggests that specific genes, perhaps those involved in affect regulation or stress responsiveness, contribute to PG and anxiety disorders. Overlapping environmental contributions to the co-occurrence of PG and PD suggest that common life experiences (e.g., early life trauma) contribute to both PG and PD. Conversely, the data suggest that distinct environmental factors contribute to PG and GAD (e.g., early onset of gambling in PG). Future studies should examine the relationship between PG and anxiety disorders amongst other populations (women and adolescents) to identify specific genetic and environmental influences that account for the manifestation of these disorders and their co-occurrences.
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Two national U.S. telephone surveys of gambling were conducted, an adult survey (age 18 and over, N = 2,631) in 1999-2000 and a youth (age 14-21, N = 2,274) survey in 2005-2007. The data from these surveys were combined to examine the prevalence of any gambling, frequent gambling and problem gambling across the lifespan. These types of gambling involvement increased in frequency during the teens, reached a high level in the respondents' 20s and 30s, and then fell off in as the respondents aged. The notion that gambling involvement generally, and especially problem gambling, is most prevalent during the teens was not supported. A comparison of the age patterns of gambling involvement and alcohol involvement showed that alcohol involvement peaks at a younger age than gambling involvement; and thus, the theory that deviant behaviors peak at an early age applies more to alcohol than to gambling.
The use of perichondrial grafts for reconstruction of the thyroid cartilage of the larynx was studied in two series of rabbits. In the first pilot study the thyroid cartilage was replaced by a cartilage performed by the neochondrogenic effect of an auricular perichondrial graft set into the defect on a subcutaneous flap. When this transplantation technique proved successful, another series was performed where a laryngeal defect of the thyroid cartilage and the underlying mucosa were replaced by a preformed composite graft. This composite graft consisted of a biological support of newly formed cartilage from the neochondrogenic effect of a free perichondrial graft and mucosal lining made of a retention cyst from a free graft of oral mucosa. The newly formed composite graft was transferred to set into the laryngeal defect on a subcutaneous flap. The reconstruction was successful and all the rabbits survived, with no respiratory distress. The newly formed cartilage offered sufficient support to the reconstructed larynx. The lining formed from the mucosa of the retention cyst consisted of undiffered stratified squamous cells. This lining membrane was sufficient to control the fibrous tissue response and maintain patency of the restored lumen.
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Traditionally, linear regression has been the technique of choice for predicting medical risk. This paper presents a new approach to modeling the second part of two-part models utilizing extensions of the generalized linear model. The primary method of estimation for this model is maximum likelihood. This method as well as the generalizations quasi-likelihood and extended quasi-likelihood are discussed. An example using medical expense data from Washington State employees is used to illustrate the methods. The model includes demographic variables as well as an Ambulatory. Care Group variable to account for prior health status.
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To develop a self-report instrument to assess diagnostic criteria and associated features of pathological gambling in order to learn more about the characteristics of individuals who seek treatment for gambling problems in a Canadian setting. Fifty-seven adults seeking treatment for gambling problems at the Addictions Foundation of Manitoba were assessed. There was substantial variation in the endorsement of Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) symptoms. Lying to family members or friends and "chasing" previous gambling losses were frequently reported, while more serious consequences (for example, relationship breakup, job losses) were less frequent. DSM-IV ratings were correlated (r = 0.59) with the South Oaks Gambling Screen. Many individuals reported gambling as a way to alleviate dysphoric mood, and 30% reported receiving mental health services in the past. Approximately 50% reported suicidal ideation, although recent suicide attempts were not common. These preliminary results of Canadian adults seeking treatment for gambling problems suggest a somewhat different profile from many United States studies, which often rely on older male pathological gamblers. More systematic investigation of the presence of major depression and other psychiatric disorders is warranted. Consistent with demographic data collected at the Addictions Foundation of Manitoba, it appears that video lottery terminals play a major role in the type of problem gambling experience seen in Canadian settings.
Article
According to the single distribution theory advocated by Rose, the prevalence of a deviant condition such as excessive alcohol consumption depends upon the average level of the corresponding characteristic in the population. The objective of this study was to establish whether the single distribution theory applies to gambling behaviour. Household gambling expenditure in the United Kingdom was examined using Family Expenditure Survey data collected before and after the introduction of a national lottery in November 1994. In cross-sectional analyses, the mean (or median) household expenditure on gambling for each region predicted the prevalence of excessive gambling in that region: the slope of the relationship in 1995-96 was equivalent to an increase of 1.2 (95% CI 0.7-1.7) points in the percentage of households gambling more than 10% of income for every increase of 1 Pound in mean household gambling expenditure. The introduction of the national lottery was associated with an increase in mean household gambling expenditure from 1.45 Pounds to 3.81 Pounds per week, and an increase in the proportion of households gambling more than 10% of total income four-fold from 0.4% to 1.7%. Among households with income of less than 200 Pounds/week, the proportion gambling more than 10% of their income increased from 0.6% to 3.2%. The single distribution theory applies to gambling behaviour. The increase in average gambling expenditure associated with the introduction of a national lottery in the United Kingdom has led to a pronounced increase in the prevalence of excessive gambling, especially in low-income households. This is likely to increase the prevalence of gambling disorders and to exacerbate social inequalities in health.
Article
This paper examines the distribution of gambling dollars in Nova Scotia, Saskatchewan and Canada and studies the impact of this spending on households. We focus first on how gambling expenditures are related to the level and source of household income as well as to other demographic characteristics such as age, education, household composition, geographical area, and sources of income. Next we analyze how gambling expenditures are distributed among those households that gamble. We show how expenditure patterns differ in the intensity of gambling as measured by the proportion of household income or total amount of dollars spent on gambling. Then we study the affects that gambling has on spending on household necessities, changes in net worth, retirement savings and household debt. Finally we determine whether gambling expenditures act as a substitute or a complement to other recreational spending on entertainment products and services. Throughout the paper we offer a comparative analysis of provincial and national data.
Article
We propose an extension to the estimating equations in generalized linear models to estimate parameters in the link function and variance structure simultaneously with regression coefficients. Rather than focusing on the regression coefficients, the purpose of these models is inference about the mean of the outcome as a function of a set of covariates, and various functionals of the mean function used to measure the effects of the covariates. A commonly used functional in econometrics, referred to as the marginal effect, is the partial derivative of the mean function with respect to any covariate, averaged over the empirical distribution of covariates in the model. We define an analogous parameter for discrete covariates. The proposed estimation method not only helps to identify an appropriate link function and to suggest an underlying distribution for a specific application but also serves as a robust estimator when no specific distribution for the outcome measure can be identified. Using Monte Carlo simulations, we show that the resulting parameter estimators are consistent. The method is illustrated with an analysis of inpatient expenditure data from a study of hospitalists.
Article
Up to 2% of adults in New Zealand can be considered problem gamblers, where the activity has an impact on the well-being of those who gamble, and often their close associates. The most common activity involves non-casino gaming machines (NCGMs). This paper explores the geography of gambling 'opportunity' at small-area scales, and finds excess provision in those areas classified as highly deprived. Geographically weighted regression has been used to investigate the possibility that the degree of inequity in NCGM provision varies across New Zealand. As machines are licensed, this provides an opportunity for policy implementation towards risk reduction.
Article
There has been considerable controversy about whether generalized social phobia (GSP) and avoidant personality disorder (APD) are redundant diagnostic categories. In light of the ongoing controversy, more data are needed to help determine whether GSP and APD are independent constructs. Data were obtained from 335 people seeking treatment for GSP at a two site clinical trial. Indicators of GSP and APD were obtained along with assessments of demographic factors, level of functioning, and indicators of related psychopathology. Confirmatory factor analyses of indicators of GSP and APD suggested a somewhat better fit for a two-factor solution. Comparisons of GSP patients with and without APD suggested that in addition to having more severe social phobia symptoms, patients with APD were more depressed on a self-report measure and had more functional impairment, thereby suggesting potential utility of the diagnostic category of APD. Furthermore, the presence of APD predicted treatment response, in that patients with APD had more change early in treatment than those without APD. APD and GSP remain highly related constructs, and different aspects of these data support and dispute the utility of the diagnosis of APD in GSP. Possible new directions in conceptualizing APD are discussed.
Article
Two studies investigated the relationship between casino proximity and gambling participation, expenditure, and pathology. In Study 1, 8,842 participants were categorized into 1 of 4 driving distances from their home to the nearest casino in the province of Quebec: 0-100 km, 100.01-200 km, 200.01-300 km, or 300.01-981 km. In Study 2, 5,158 participants, who lived within a 100-km driving distance from the Montreal casino, were classified into 1 of 5 equidistant, 20-km driving distances. A survey company interviewed participants regarding their gambling habits. Results indicated a positive link between casino proximity and gambling participation (at the provincial and Montreal levels) and expenditure (at the provincial level only) but no link with the current prevalence rate of probable pathological gambling or of problem gambling. In a setting in which many types of gambling activities are available, casino proximity in itself does not appear to explain the rate of gambling-related problems. It is necessary to continue prospective research on exposure and adaptation theories as potential explanations for the development of pathological gambling.
Report produced for the Association of British Bookmakers
  • M Griffiths
Prevention of problem gambling: A comprehensive review of the evidence. Report prepared for the Ontario Problem Gambling Research Centre
  • R J Williams
  • B L West
  • R I Simpson