Anxiety Disorders among Gambling Addicts

Abstract

Introduction: Anxiety is an emotion generated by the anticipation of a diffuse, difficult to predict and control danger. Professionals in mental health consider that approximately 40% of gambling addicts have an anxiety disorder at least once in life.
Objectives: This paper aims to underline the existence of different forms of anxiety among gambling addicts.
Methods: We used for this research 119 gambling addicts who were tested according to Hamilton Anxiety Rating Scale.
Results: According to the statistical data obtained, 64.71% of the subjects showed a form of anxiety.
Conclusions: Results of the research validated the initial hypothesis according to which a significant percent of gambling addicts have different intensities of anxiety.

Full text

Anxiety Disorders among Gambling Addicts
Steliana Rizeanu*
Department of Psychology, Hyperion University of Bucharest, Romania
*Corresponding author: Steliana Rizeanu, Department of Psychology, Hyperion University of Bucharest, Romania, Tel: +40-213274465; E-mail:
stelianarizeanu@yahoo.com
Received date: June 19, 2018; Accepted date: July 12, 2018; Published date: July 16, 2018
Copyright: ©2018 Rizeanu S. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use,
distribution and reproduction in any medium, provided the original author and source are credited.
Abstract
Introduction: Anxiety is an emotion generated by the anticipation of a diffuse, difficult to predict and control
danger. Professionals in mental health consider that approximately 40% of gambling addicts have an anxiety
disorder at least once in life.
Objectives: This paper aims to underline the existence of different forms of anxiety among gambling addicts.
Methods: We used for this research 119 gambling addicts who were tested according to Hamilton Anxiety Rating
Scale.
Results: According to the statistical data obtained, 64.71% of the subjects showed a form of anxiety.
Conclusions: Results of the research validated the initial hypothesis according to which a significant percent of
gambling addicts have different intensities of anxiety.
Keywords: Anxiety disorders; Gambling addicts; Comorbidity
Introduction
Anxiety is one of the most frequent disorders met in the psychiatry
and is characterised by a diuse and unpleasant feeling of fear and
restlessness, accompanied by vegetative symptoms: headache,
perspiration, palpitations, tachycardia, and gastric discomfort [1].
Pathological anxiety appears when the daily functionality is aected by
unsuitable reactions to interior conicts or due to the anticipation of a
potential threat.
Gambling has unprecedentedly developed during the last years and
caused devastating negative consequences for gamblers and their
families. Robson et al. [2] specied that the normal gambler, who does
not show any form of addiction, allocates to this activity less than 5%
of his monthly budget and gambles maximum one day per week, for
not more than 3 hours.
Specialists in the eld estimate that the prevalence of gambling
addiction among population is between 0.8% and 5% of adults [3],
higher percent being reported for teenagers: 5.2% in USA, 6.4% in
Canada [4]; 4.4% in Australia; 5.6% in England [5]; 4.5% in Spain;
3.6% in Serbia [6]. A systematic review conducted by Calado et al. [7]
since 2000 to 2015 concluded that the gambling rates in Europe and
dierent countries in the world is among 0.12% and 5.8%.
Gambling addiction has the following negative consequences:
depression, suicidal thoughts, anxiety, alcohol and drug consumption,
diculties in keeping a job, lies and deception, the decrease of
cognitive performance, physical symptoms [8-10].
ere are numerous studies which associate anxiety and gambling
addiction [11-15].
Anxiety aects thinking, perception and learning; it can distort
perceptions and decrease the power of focus, associative and evocative
memory. From a psych-physiological point of view, a series of
manifestations are characteristic to anxiety: tremor, headaches,
increase of blood pressure, perspiration, modication of the muscular
tonus, modication of the electric conductance of the skin as well as
the modication of the cardio frequency.
A meta-analysis of studies done in the USA, Korea, Canada and
Switzerland between 1998 and 2010 revealed that 60.1% of the
addicted gamblers have at the same time a nicotine addiction, 57.5%
use substances, 37.9% show mood changes and 37.4% have at least one
form of anxiety [16].
e objective of this paper is to show that addicted gamblers show
dierent types of anxiety.
e hypothesis of the research is that there is a signicant positive
association between gambling addiction and anxiety among
participants in the study.
Method
Participants
is study used a sample of 119 addicted gambler aged between 17
and 61, 7 women and 112 men, 74 of them highly educated and 45
with secondary education. 95 subjects (79.8%) declared they were
married, while 24 (20.2%) were unmarried; 48 subjects come from
rural areas and 71 from urban areas.
As concerning employment, 25 subjects were unemployed; 12 were
students and the rest of 82 subjects had a stable job. e subjects were
selected from people who approached a centre of psychological
J
o
u
r
n
a
l
o
f
A
l
c
o
h
o
l
i
s
m
a
n
d
D
r
u
g
D
e
p
e
n
d
e
n
c
e
ISSN: 2329-6488
Journal of Alcoholism & Drug
Dependence
Rizeanu, J Alcohol Drug Depend 2018, 6:3
DOI: 10.4172/2329-6488.1000315
Short Communication Open Access
J Alcohol Drug Depend, an open access journal
ISSN: 2329-6488
Volume 6 • Issue 3 • 1000315

counselling for gambling addiction and obtained scored bigger than 5
at South Oaks Gambling Screen, which allowed us to consider them
addicted gamblers.
Instruments and Procedure
For the purposes of this research we used 2 instruments: South Oaks
Screen-SOGS [17] and Hamilton Anxiety Rating Scale-HAM-A [18].
South Oaks Gambling Screen-SOGS is the most used instrument to
diagnose gambling addiction. It was created in 1987 by Lesieur and
Blume and contains 20 items which correlate with the criteria for
diagnosing gambling from DSM-IV-TR. e advantage of SOGS is the
easiness in applying and the way of counting the score as well as the
fact that it proved to be useful in diagnosing gambling at both adults
and teenagers.
Hamilton Anxiety Rating Scale (HAM-A) is an instrument used to
evaluate anxiety, which contains 14 items developed for the rst time
by Hamilton (1959). is scale provides a global evaluation of anxiety
and identies psychic as well as somatic symptoms and can be used to
detect symptoms of anxiety and to evaluate their severity.
Results
Aer applying South Oaks Gambling Screen the researched sample
(N=119) obtained an average value of the score of 10.55; the lowest
score was 7 and the highest 14, both of them indicating a form of
gambling addiction (Table 1).
Total SOGS
N
Valid 119
Missing 0
Mean 10,55
Median 10,00
Mode 9
Standard deviation 1,784
Skewness ,059
Kurtosis -1,139
Minimum 7
Maximum 14
Table 1: Statistical indicators: SOGS.
Aer applying Anxiety Rating Scale-HAM-A, the researched sample
(N=119) obtained an average value of the score for anxiety of mg
1=15.08, which is the inferior limit of the area of moderate anxiety
(Table 2). As concerning the standard deviation of the scores from the
average (10.411), this value indicates a division of the data
characteristic to a homogeneous population as degree of anxiety
(Figure 1).
Total Anxiety
N
Valid 119
Missing 0
Mean 15,08
Median 13,00
Mode 5
Standard deviation 10,411
Skewness 413
Kurtosis -1,228
Minimum 2
Maximum 39
Table 2: Statistical indicators: HAM-A.
e distribution of the scores is the following: 29.41% of subjects
show a moderate form of anxiety; 26.05% show a mild anxiety and
9.24% have a severe form of anxiety.
Figure 1: HAM-A score distribution.
Discussion
e hypothesis of the paper is that addicted gamblers could suer
from anxiety at the same time. e results obtained aer applying the
tests validate out hypothesis: 64.71% of the subjects have at the same
time a form of anxiety.
ese results correspond to the results of other studies done
internationally and which showed signicant correlations between
gambling addiction and anxiety and depression disorders [19-25].
Conclusion
e measures to prevent the emergence of gambling addiction and
mitigate associated risks, including the development of anxiety, are
centered on the assumption that adults assume responsibility for their
own choices, as public perception is that the governments and
promoters of gambling bear all the responsibility for the negative
consequences associated with gambling addiction.
Disley et al. [26] believed that primary prevention measures refer to
warning campaigns done by the media, online information centers,
youth education initiatives, and corporate programs that promote
responsible gaming.
Specialists in the eld of mental health believe that providing
psychological counseling for gambling addiction is eective if it meets
the following conditions: it is free; addresses both game and related
Citation: Rizeanu S (2018) Anxiety Disorders among Gambling Addicts. J Alcohol Drug Depend 6: 315. doi:10.4172/2329-6488.1000315
Page 2 of 3
J Alcohol Drug Depend, an open access journal
ISSN: 2329-6488
Volume 6 • Issue 3 • 1000315

addictions and is carried out both individually and within the family of
addicts, under conditions of complete condentiality.
In Romania, the "Responsible Gambling" program was set up to
prevent the emergence of gambling addiction and to promote a
responsible social gambling, which is assigned a pre-dened amount of
money and a limited amount of time [27,28]. Within this program, a
team of psychologists oers free psychological counseling to troubled
gamblers and their partners, under condentiality.
References
1. American Psychiatric Association (2000) Diagnostic and Statistical
Manual of Mental Disorders. Washington, DC: Author.
2. Robson EM, Edwards J, Smith G, Newman S (2006) Investigating the
ecacy of the Gambling Decisions program in three Alberta
communities: report of the one year Community trial. Edmonton, AB:
Capital Health, Public Health.
3. Molde H, Ingjaldsson J, Kvale G, Pallesen S, Stoylen IJ, et al. (2004)
Pathological gambling-assessment, prevalence, aetiology and treatment.
Tidsskri for Norsk Psykologforening 41: 703-722.
4. Poulin C (2000) Problem Gambling Among Adolescent Students in the
Atlantic Provinces of Canada. J Gambl Stud 16: 53-78.
5. Fisher S (1999) A prevalence study of gambling and problem gambling in
British adolescents. Addiction Research 7: 509-538.
6. Rizeanu S (2014) e ecacy of cognitive-behavioral intervention in
pathological gambling treatment. Procedia-Social and
Behavioral Sciences. 127: 626-630.
7. Calado F, Griths MD (2016) Problem gambling worldwide: An update
and systematic review of empirical research (2000-2015). J Behav Addict
5: 592-613.
8. Rizeanu S (2012) e Specicity of Pathological Gambling. Procedia -
Social and Behavioral Sciences by Elsevier 33: 1082-1086.
9. Rizeanu S (2013a) Pathological gambling and depression. Procedia-Social
and Behavioral Sciences by Elsevier. 78: 501-505.
10. Rizeanu S (2018) Cognitive-behavioral therapy for gambling addiction, in
Cognitive behavioral therapy and clinical applications, Dr. Ömer
Şenormancı (Ed.) pp: 61-81.
11. Crockford D, El-Guebaly N (1998) Psychiatric co-morbidity in
pathological gambling: A critical review. Canadian Journal of Psychiatry
43: 43-50.
12. Hodgins DC, Peden N, Cassidy E (2005) e Association Between
Comorbidity and Outcome in Pathological Gambling: A Prospective
Follow-up of Recent Quitters. J Gambl Stud 21: 255-271.
13. Rizeanu S (2013b) Pathological Gambling in Relation to Anxiety and
Identity Status. Procedia-Social and Behavioral Sciences pp: 748-752.
14. Westphal JR, Johnson LJ (2007) Multiple co-occuring behaviours among
gamblers in treatment: Implications and assessment. International
Gambling Studies 7: 73-99.
15. Zangeneh M, Grunfeld A, Koenig S (2008) Individual factors in the
development and maintenance of problem gambling. In M. Zangeneh, A.
Blaszczynski, & N.E. Turner (Eds.), In the pursuit of winning: Problem
gambling theory, research and treatment pp: 83-94. New York: Springer
Science and Business Media.
16. Lorains FK, Cowlishaw S, omas SA (2011) Prevalence of comorbid
disorders in problem and pathological gambling: systematic review and
meta-analysis of population surveys. Addiction 106: 490-498.
17. Lesieur HR, Blume SB (1987) e South Oaks Gambling Screen (SOGS):
A new instrument for the
identication of pathological gamblers. Am J Psychiatry 144: 1184-1188.
18. Hamilton M (1959) e assessment of anxiety states by rating. British
Journal of Medical Psychology 32: 50-55.
19. Blaszczynsky A (2010) Overcoming compulsive gambling. London:
Robinson.
20. Korn DA, Schaer HJ (2004) Massachusetts Department of Practice
Health’ Practice Guidelines for Treating Gambling-Related Problems. An
Evidence-Based Treatment Guide for Clinicians. Toronto: Massachusetts
Council on Compulsive Gambling.
21. Momper SL, Delva J, Grogan-Kaylor A, Sanchez N, Volberg RA (2010)
e association of at-risk, problem, and pathological gambling with
substance use, depression, and arrest history. J Gambl Issues 24: 7-32.
22. Fernández-Montalvo J, Echeburúa E (2004) Pathological gambling and
personality disorders: an exploratory study with the IPDE. J Pers Disord
18: 500-505.
23. Raylu N, Oei TP (2010) A cognitive behavioural therapy programme for
problem gambling. East Sussex: Routledge.
24. Rizeanu S (2015) Responsible Gambling in Romania. Journal of Addictive
Behaviors, erapy and Rehabilitation 4: 3.
25. Rizeanu S, Vezeteu E (2017) Incidence of problem gambling in Romania.
Brief report. J Psychol Brain Stud 1: 1-4.
26. Disley E, Pollitt A, Culley DM, Rubin J (2011) Map the Gap, a critical
review of the literature on gambling-related harm. Santa Monica: RAND
Corporation.
27. Williams RJ, West B, Simpson R (2007) Prevention of problem gambling:
a comprehensive review of the evidence. Guelph: Ontario Problem
Gambling Research Centre.
28. Petry NM, Stinson FS, Grant BF (2005) Comorbidity of DSM-IV
pathological gambling and other psychiatric disorders: Results from the
National Epidemiologic Survey on alcohol and related conditions.
J Clin Psychiatry 66: 564-574.
Citation: Rizeanu S (2018) Anxiety Disorders among Gambling Addicts. J Alcohol Drug Depend 6: 315. doi:10.4172/2329-6488.1000315
Page 3 of 3
J Alcohol Drug Depend, an open access journal
ISSN: 2329-6488
Volume 6 • Issue 3 • 1000315