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14 CitationsRelationship between pathological gambling, alcoholism and drug addiction
Abstract
The aim of this survey was to evaluate the distribution of pathological gamblers treated in an alcohol or drug addiction treatment program run by the Italian National Health Service providing assistance to alcohol and drug abusers in Venice (North east Italy) from September 1 to December 31, 2001. Each drug- or alcohol-dependent patient retained for treatment for at least one month was administrated an anonymous precoded questionnaire to collect personal and socio-demographic features. The South Oaks Gambling Screen (SOGS) was used to measure pathological gambling and the Symptom Checklist-90-Revised (SCL-90-R) to measure psychological distress levels and psychiatric symptoms. Among the 113 enrolled subjects we found a greater prevalence of pathological gamblers among drug users than among alcoholics and drug abusers were younger than alcoholics; moreover, there was a prevalence of single status, low schooling, and a low-medium income despite full-time occupation. Only pathological gamblers revealed a significant positive correlation with a family history of gambling and reached positive scores (>1.5) for some likely psychiatric symptoms. Abuse disorders and pathological gambling are frequently associated with multidependence personality traits. Preventing substance abuse may reduce the pathological gambling rates and better results can be obtained with educational campaigns beginning earlier in life.
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- Numbers gambling, or " policy, " has long been popular in deprived communities (Ferentzy & Turner, 2009) and in some samples being African American has also been identified as a risk factor for frequent gambling or PG among persons with SUD (Barnes, Welte, Hoffman, & Tidwell, 2009; Cunningham- Williams et al., 2000; Petry & Tawfik, 2001). In a sample of 113 persons with SUD Baldo et al., (2006) found lower levels of schooling and income to be associated with PG.
[Show abstract] [Hide abstract] ABSTRACT: Problem gambling, substance use disorders, and their cooccurrence are serious public health concerns. We conducted a comprehensive review of the literature to understand the present state of the evidence on these coaddictions. Our main focus was illicit drug use rather than misuse of legal substances. The review covers issues related to gambling as a hidden problem in the illicit drug use community; prevalence, problem gambling, and substance use disorders as kindred afflictions; problem gambling as an addiction similar to illicit drug use; risk factors and problems associated with comorbidity, and gender issues. We end with some suggestions for future research.- For instance, the most comprehensive of these studies, the University of Michigan National Comorbidity Survey Replication found that 31.8% of patients with PG were diagnosed with SUDs (Kessler et al., 2008 ). Notably outpatient addiction programs tend to focus more on substance addictions so that a significant portion of patients who are already receiving treatment for SUDs have lingering gambling pathology (de Carvalho et al., 2005; Baldo et al., 2006; ANPAA et al., 2011), ranging from 10.8% (de Carvalho et al., 2005) to 12% (ANPAA et al., 2011) for PrG and 6.5% (ANPAA et al., 2011) to 18.9% (de Carvalho et al., 2005) for PG. Although legalized gambling purportedly advances local economies, concerns have been raised about its potential liability to increase the level of problematic gambling and of drug consumption and thus to worsen patients' clinical status (Welte et al., 2004; Cotti and Walker, 2010).
[Show abstract] [Hide abstract] ABSTRACT: Background: Parallel to the ongoing expansion of legalized gambling activities is a growing concern about rising occurrence of uncontrollable gambling. People with preexisting gambling and/or chemical addictions may be particularly vulnerable, but the extent of such co-occurring conditions and their demographic and clinical characteristics have not been sufficiently elucidated. To that end, the present study attempted to both, quantify the presence and to characterize co-occurring pathological or problem gambling (ie, respectively, at least 1- or at least 5 pathological gambling criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision) among treatment-seeking patients at a community outpatient addiction program. Methods: The patients were assessed with the South Oaks Gambling Screen and their charts were reviewed for the extraction of demographic and clinical information according to a predetermined template. Data from 183 subjects withstood quality control procedures and were included. Results: The prevalence rates of co-occurring problem- (18.6%) and pathological (10.9%) gambling were strikingly higher than those found in the general population (2% and 0.5%, respectively). No increase in the clinical severity indices was observed across the gambling groups. Conclusions: Our data replicate those of prior studies reporting heightened prevalence of problematic gambling in patients with substance use disorders and extend the prior findings by including a subject population of treatment-seekers. In the era of the gambling industry growth, these results call for creation and/or adjustment of clinical addiction services to meet emerging preventive and therapeutic needs.- The common quoted figure for problem or pathological gambling worldwide is between 0.5% and 2% (Productivity Commission, 2010; Thomas et al., 2011; Volberg, 2004). It is well documented that most people who get into difficulty with gambling experience a range of problems, including mental health issues such as depression and anxiety (Goodyear-Smith et al., 2006; Kim, Grant, Eckert, Faris, & Hartman, 2006; Quilty, Watson, Robinson, Toneatto, & Bagby, 2011) and dependence problems of alcohol and substance misuse (Baldo et al., 2006; Griffiths, Wardle, Orford, Sproston, & Erens, 2010; Hodgins, & el-Guebaly, 2010; Kaminer & Haberek, 2004). A major professional concern is the ability to identify and help those suffering from a particular condition as soon as possible.
[Show abstract] [Hide abstract] ABSTRACT: Cognitive-Behaviour Therapy (CBT) is considered the number one non-pharmacological treatment for a number of mental and psychological disorders (Tolin, 2010; Stuhlmiller & Tolchard, 2009). While CBT with problem gamblers has shown promise, the quality of the research in this area is lacking. One area of concern is that across the many trials and reports using CBT with gamblers no single unified approach has been used and so comparison across studies is limited. Similarly, translation of the CBT research into clinical practice is almost entirely absent (Walker, 2005). This article will explore the concepts of CBT with problem gamblers and identify common elements across all reported approaches. A unified model of CBT with problem gamblers will be suggested and the direct clinical application of this model described from a state-wide gambling service in Australia (Flinders Approach) with 205 problem gamblers. The results indicate that the Flinders Approach is successful in treating gamblers considered to be at the severest end of the experience, with a 69% completion rate. Implications for future research in which this model may be tested against other therapies and pharmacological treatments will be discussed.- One of the main therapeutic approaches to the treatment of gambling is Cognitive- Behavior Therapy—CBT (Ladouceur et al. 2001; Tolchard and Battersby 2000; Tolchard et al. 2006). More widespread use of the VGS and speedy referral to evidence based services (CBT) would reduce some of the problems associated with gambling such as high co-morbidity of mental health problems (Baldo et al. 2006; Delfabbro et al. 2006; Erickson et al. 2005; Henderson 2004; Lynch et al. 2004) and suicide (Battersby et al. 2006; Ledgerwood and Petry 2004; Newman and Thompson 2003).
[Show abstract] [Hide abstract] ABSTRACT: There is a need to establish reliability and the various forms of validity in all measures in order to feel confident in the use of such tools across a wide diversity of settings. The aim of this study is to describe the reliability and validity of the Victorian Gambling Screen (VGS) and in particular one of the sub-scales (Harm to Self-HS) in a specialist problem gambling treatment service in Adelaide, Australia. Sixty-seven consecutive gamblers were assessed using a previously validated clinical interview and the VGS (Ben-Tovim et al., The Victorian Gambling Screen: project report. Victorian Research Panel, Melbourne, 2001). The internal consistency of the combined VGS scales had a Cronbach's alpha of .85 with the HS scale .89. There was satisfactory evidence of convergent validity which included moderate correlations with another measure of gambling-the South Oaks Gambling Screen. There were also moderate correlations with other measures of psychopathology. Finally, how the VGS may best be used in clinical settings is discussed.- Studies have found that pathological gambling is associated with marital conflict, child neglect, domestic violence, criminal involvement, and juvenile delinquency (Hodgins et al., 2006; Kausch, 2003; Maccallum and Blaszczynski, 2003; Newman and Thompson, 2003; Petry and Kiluk, 2002) and comorbid psychiatric illness (Baldo et al., 2006; Borras and Huguelet, 2007; Petry, 2007; Potenza and Chambers, 2001), and mood disorders in particular (for a review, see Kim et al., 2006). Limited studies on treatment-seeking individuals support a relationship between pathological gambling and suicidal ideation and attempt (for a review, see Hodgins et al., 2006).
[Show abstract] [Hide abstract] ABSTRACT: Pathological gambling is associated with suicidal ideation and attempt. There is no known report on pathological gambling preceding suicide. By examining a series of 17 suicide cases with evidence of pathological gambling prior to death, we sought to generate hypotheses for further study of this under-researched but rapidly-increasing worldwide public health problem. Psychological autopsy interviews using a semi-structured format were conducted with proxy respondents for suicide and control subjects aged 15-59 years in Hong Kong SAR, China. Of the 150 suicides and 150 controls examined, 17 suicides (11.3%) and one control case (0.6%) met criteria for the diagnosis of pathological gambling at the time of death or interview. All 17 suicide cases with pathological gambling had unmanageable debt at the time of death. Fourteen cases (82.4%) had other associated psychiatric disorders, most often major depressive disorders (n=10, 58.9%) and substance-use disorders (n=3, 17.6%). None had ever received psychiatric treatment. Descriptive, retrospective case series with a small sample size. Along with unmanageable debt, a high proportion of the suicide cases with pathological gambling also experienced other psychiatric illnesses, most often depression, at the time of death. None sought treatment for their addictive behavior or psychiatric illness prior to death. Pathological gambling is a modifiable risk factor for suicide for which means to enhance case identification and engagement in treatment are urgently needed. Clinicians treating depression should explore the presence of pathological gambling behavior or unmanageable debts among their patients. Addressing pathological gambling should be one important component of a comprehensive suicide prevention strategy especially in countries where gambling activities are legalized and expanding.- The common quoted figure for problem or pathological gambling worldwide is between 0.5% and 2% (Productivity Commission, 2010; Thomas et al., 2011; Volberg, 2004). It is well documented that most people who get into difficulty with gambling experience a range of problems, including mental health issues such as depression and anxiety (Goodyear-Smith et al., 2006; Kim, Grant, Eckert, Faris, & Hartman, 2006; Quilty, Watson, Robinson, Toneatto, & Bagby, 2011) and dependence problems of alcohol and substance misuse (Baldo et al., 2006; Griffiths, Wardle, Orford, Sproston, & Erens, 2010; Hodgins, & el-Guebaly, 2010; Kaminer & Haberek, 2004). A major professional concern is the ability to identify and help those suffering from a particular condition as soon as possible.
[Show abstract] [Hide abstract] ABSTRACT: The cognitive behavioral therapy (CBT) approach used within the unit for the treatment of problem gambling is based on the same principles used to treat clients with anxiety disorders and depression. This approach is based on the work of Isaac Marks (Marks, 1986) and was introduced by Battersby (Tolchard and Battersby, 2000) to South Australia in 1996. The service is part of the Break Even network funded by the South Australian government Department of Families and Communities and is integrated with the Mental Health Sciences postgraduate courses in cognitive-behavioral therapy for health professionals at Flinders University, Adelaide, Australia. This chapter provides an outline of the theoretical framework, assessment process, specific treatment methods, and measurement of treatment outcomes of the Flinders Therapy Service for Problem Gamblers. A case example and outcome data are provided to demonstrate the treatment model and its effectiveness. An overview of treatment outcomes for problem gambling assessing different modalities is discussed. Cognitive therapy is used initially to dispute irrational beliefs related to gambling, and to help recognize and modify the negative automatic thought processes that clients may have that can cause and maintain psychological distress. The behavioral approach aims to extinguish the client's urge to gamble. This treatment enables mastery over and elimination of the urge to gamble, which facilitates recovery both in gambling behavior and functional recovery in the person's life. Once mastery of the urge to gamble has occurred, secondary control measures become unnecessary. The treatment process is described in this chapter, with the main focus being on gaming machine addiction. This approach can be used for other forms of gambling such as horse race betting, casino games, and sports betting.
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