AIMS:To derive low-risk gambling limits using the method developed by Currie et al. (2006) applied to longitudinal data.DESIGN:Secondary analysis of data from the Quinte Longitudinal Study (n = 3054) and Leisure, Lifestyle and Lifecycle Project (n = 809), two independently conducted cohort studies of the natural progression of gambling in Canadian adults.SETTING:Community-dwelling adults in Southeastern Ontario and Alberta, Canada.PARTICIPANTS:A total of 3863 adults (50% male; median age = 44) who reported gambling in the past year.MEASUREMENTS:Gambling behaviours (typical monthly frequency, total expenditure and percentage of income spent on gambling) and harm (experiencing two or more consequences of gambling in the past 12 months) were assessed with the Canadian Problem Gambling Index.FINDINGS:The dose-response relationship was comparable in both studies for frequency of gambling (days per month), total expenditure and percentage of household income spent on gambling (area under the curve values ranged from 0.66 to 0.74). Based on the optimal sensitivity and specificity values, the low-risk gambling cut-offs were eight times per month, $75CAN total per month and 1.7% of income spent on gambling. Gamblers who exceeded any of these limits at time 1 were approximately four times more likely to report harm at time 2 [95% confidence interval (CI) = 2.9-6.6].CONCLUSIONS:Longitudinal data in Canada suggest low-risk gambling thresholds of eight times per month, $75CAN total per month and 1.7% of income spent on gambling, all of which are higher than previously derived limits from cross-sectional data. Gamblers who exceed any of the three low-risk limits are four times more likely to experience future harm than those who do not.
The objective of the current study was to examine the possible temporal associations between alcohol misuse and problem gambling symptomatology from adolescence through to young adulthood. Parallel-process latent growth curve modeling was used to examine the trajectories of alcohol misuse and symptoms of problem gambling over time. Data were from a sample of adolescents recruited for the Leisure, Lifestyle, and Lifecycle Project in Alberta, Canada (n = 436), which included 4 assessments over 5 years. There was an average decline in problem gambling symptoms followed by an accelerating upward trend as the sample reached the legal age to gamble. There was significant variation in the rate of change in problem gambling symptoms over time; not all respondents followed the same trajectory. There was an average increase in alcohol misuse over time, with significant variability in baseline levels of use and the rate of change over time. The unconditional parallel process model indicated that higher baseline levels of alcohol misuse were associated with higher baseline levels of problem gambling symptoms. In addition, higher baseline levels of alcohol misuse were associated with steeper declines in problem gambling symptoms over time. However, these between-process correlations did not retain significance when covariates were added to the model, indicating that one behavior was not a risk factor for the other. The lack of mutual influence in the problem gambling symptomatology and alcohol misuse processes suggest that there are common risk factors underlying these two behaviors, supporting the notion of a syndrome model of addiction.
Background: The current study sought to explore the narrative accounts of individuals who underwent changes in their problem gambling severity, and identify subjective factors underlying these transitions. Additionally, respondents' perceived change in their gambling behavior was compared with a validated measure of problem gambling severity.Methods: Participants were recruited from The Leisure, Lifestyle, & Lifecycle Project (LLLP), a prospective cohort study based in Alberta, Canada. In-depth, semi-structured telephone interviews were conducted with a subset of participants identified as showing a significant increase or decrease in problem gambling severity between Wave 4 and 5 of the LLLP (n=41). Principles of phenomenology and grounded theory were used to thematically code interviews.Results: About half of respondents increased in problem gambling severity between Wave 4 and 5 (n=22), while 19 respondents decreased. For those who perceived this change (n=13), the most common factors underlying increases in problem gambling severity were the same factors underlying decreases and included financial, social, and internal reasons. More than half of the sample (n=28) perceived stability in, or a change in their gambling behavior that was incongruent with their problem gambling severity score. These respondents tended to endorse a greater degree of gambling fallacies, dissonant feelings, and mental health issues, compared to those who had accurately perceived their change.Conclusions: The findings suggest that many individuals may not accurately perceive transitions in their gambling. Gambling fallacies and dissonant feelings seem to underlie this discrepancy, highlighting the need for public health initiatives to focus on correcting these erroneous beliefs.
Disordered gambling is best conceptualized as a continuum of severity. Previous research has demonstrated the utility of studying individuals at all points of this spectrum. The sequence of the development of gambling problems and change in gambling involvement along this continuum of severity is not well understood. The present study examined the interplay between cognitive distortions and gambling involvement in a population sample recruited in Alberta, Canada. Data from 1372 participants over 4 assessment waves (5 years) were used to generate a 2-factor latent structure using gambling fallacies and gambling involvement measurements. Structural equation modelling showed that cognitive distortions more strongly predicted future gambling involvement than the reverse relationship, using the comparative fit index (CFI) and the root mean square error of approximation (RMSEA) to assess the models. In addition, cognitive distortions declined over time, whereas gambling involvement remained stable. The results of the study suggest that focusing primarily on cognitive mechanisms in public health initiatives for gambling disorders may be a more effective strategy than focusing on behavioural solutions.
This study investigated the degree to which facets of impulsiveness predicted future binge eating and problem gambling, 2 theorized forms of behavioral addiction. Participants were 596 women and 406 men from 4 age cohorts randomly recruited from a Canadian province. Participants completed self-report measures of 3 facets of impulsiveness (negative urgency, sensation seeking, lack of persistence), binge-eating frequency, and problem-gambling symptoms. Impulsiveness was assessed at baseline, and assessments of binge eating and problem gambling were followed up after 3 years. Weighted data were analyzed using zero-inflated negative binomial and Poisson regression models. We found evidence of transdiagnostic and disorder-specific predictors of binge eating and problem gambling. Negative urgency emerged as a common predictor of binge eating and problem gambling among women and men. There were disorder-specific personality traits identified among men only: High lack-of-persistence scores predicted binge eating and high sensation-seeking scores predicted problem gambling. Among women, younger age predicted binge eating and older age predicted problem gambling. Thus, there are gender differences in facets of impulsiveness that longitudinally predict binge eating and problem gambling, suggesting that treatments for these behaviors should consider gender-specific personality and demographic traits in addition to the common personality trait of negative urgency.
Major depression is among the most common comorbid conditions in problem gambling. However, little is known about the effects of comorbid depression on problem gambling. The present study examined the prevalence of current major depression among problem gamblers (N = 105) identified from a community sample of men and women in Alberta, and examined group differences in gambling severity, escape motivation for gambling, family functioning, childhood trauma, and personality traits across problem gamblers with and without comorbid depression. The prevalence of major depression among the sample of problem gamblers was 32.4%. Compared to problem gamblers without depression (n = 71), problem gamblers with comorbid depression (n = 34) reported more severe gambling problems, greater history of childhood abuse and neglect, poorer family functioning, higher levels of neuroticism, and lower levels of extraversion, agreeableness, and conscientiousness. Furthermore, the problem gamblers with comorbid depression had greater levels of childhood abuse and neglect, worse family functioning, higher neuroticism, and lower agreeableness and conscientiousness than a comparison sample of recreational gamblers with depression (n = 160). These findings underscore the need to address comorbid depression in assessment and treatment of problem gambling and for continued research on how problem gambling is related to frequently co-occurring disorders such as depression.
Introduction. To report on highlights of a longitudinal study of gamblers, the Alberta Leisure, Lifestyle, Lifecycle Project (LLLP) as well as comparisons with the Ontario Quinte Study. Method. Five LLL cohorts of gamblers (ages 13–15, 18–20, 23–25, 43–45, and 63–65) have been recruited through Random Digit Dialing (RDD) since February 2006. The cohorts are stratified by large and small urban centers and over-sampled for at-risk gamblers. Four data collections have occurred with initial telephone and face-to-face interviews, followed by web-based surveys. The selection of survey instruments reflected a biopsychosocial model of gambling. Results. Recruitment at Time 1: N = 1808 – Feb – Oct ′06; Time 2: N = 1495 – Nov ′07 – Jun ′08; Time 3: N = 1316 – Jul ′09 – Mar ′10; and Time 4: N = 1343 – Feb – Oct ′11. (Overall Retention Rate 75.1% – 20 deceased). In addition, N = 679 blood and saliva samples were collected. For comparison, the Quinte study had N = 4121 and a Retention Rate 90.4% over 5 time intervals. Highlights include. 1. an analysis of patterns of continuity/discontinuity of problem gambling over 5 years; 2. identification of variables best predicting future problem gambling, coordinated with the Quinte study. Conclusion. Longitudinal studies provide unique insights into the trajectory of gambling behaviors.
The Problem Gambling Severity Index (PGSI) is a widely used nine item scale for measuring the severity of gambling problems in the general population. Of the four gambler types defined by the PGSI, non-problem, low-risk, moderate-risk and problem gamblers, only the latter category underwent any validity testing during the scale's development, despite the fact that over 95% of gamblers fall into one of the remaining three categories. Using Canadian population data on over 25,000 gamblers, we conducted a comprehensive validity and reliability analysis of the four PGSI gambler types. The temporal stability of PGSI subtype over a 14-month interval was modest but adequate (intraclass correlation coefficient = 0.63). There was strong evidence for the validity of the non-problem and problem gambler categories however the low-risk and moderate-risk categories showed poor discriminant validity using the existing scoring rules. The validity of these categories was improved with a simple modification to the scoring system.
The Problem Gambling Severity Index (PGSI), a screening tool used to measure the severity of gambling problems in general population research, was subjected to confirmatory factor analysis and Rasch modelling to (a) confirm the one‐factor structure; (b) assess how well the items measure the continuum of problem gambling severity; (c) identify sources of differential item functioning among relevant subpopulations of gamblers. Analyses were conducted on a nationally representative sample of over 25,000 gamblers compiled by merging data from the Canadian Community Health Survey and Canadian Problem Gambling Index (CPGI) integrated datasets. Results provided support for a one‐factor model that was invariant across gender, age, income level, and gambler type. Rasch modelling revealed a well‐fitting, unidimensional model with no miss‐fitting items. The average severity assessed by the PGSI is consistent with moderately severe problem gambling. The PGSI is therefore weak in assessing low to moderate problem severity, a notable limitation of most brief gambling screens. Evidence of clinically significant differential item functioning was found with only one item, borrowing money to gamble, which behaved differently in gamblers who play electronic gaming machines or casino games compared to gamblers who avoid these games. Copyright © 2013 John Wiley & Sons, Ltd.
Albertans representing five age cohorts (13–15, 18–20, 23–25, 43–45 and 63–65) were surveyed (n = 1809) to assess their attitudes toward gambling in general, gambling in Alberta and legal gambling's impacts in the province. Age, gender and problem gambling status were found to be reliable predictors of gambling attitudes in that younger male, non-problem gamblers were most approving of the activity. Results also indicate that Albertans are ambivalent about gambling and that gambling and public policy are mis-aligned to the extent that gambling's harms are thought to outweigh its benefits. Likely reasons for the gap between gambling policy and public opinion are that gambling issues lack the salience of ongoing high-profile topics such as the economy, health care, education and the environment, and gambling dependent special interest groups can exert considerable influence on gambling policy in ways that may not harmonise with the public interest.
AIMS To assess the impact of gambling above the low-risk gambling limits developed by Currie et al. (2006) on future harm. To identify demographic, behavioural, clinical and environmental factors that predict the shift from low- to high-risk gambling habits over time. DESIGN Longitudinal cohort study of gambling habits in community-dwelling adults. SETTING Alberta, Canada. PARTICIPANTS A total of 809 adult gamblers who completed the time 1 and time 2 assessments separated by a 14-month interval. MEASUREMENTS Low-risk gambling limits were defined as gambling no more than three times per month, spending no more than CAN$1000 per year on gambling and spending less than 1% of gross income on gambling. Gambling habits, harm from gambling and gambler characteristics were assessed by the Canadian Problem Gambling Index. Ancillary measures of substance abuse, gambling environment, major depression, impulsivity and personality traits assessed the influence of other risk factors on the escalation of gambling intensity. FINDINGS Gamblers classified as low risk at time 1 and shifted into high-risk gambling by time 2 were two to three times more likely to experience harm compared to gamblers who remained low risk at both assessments. Factors associated with the shift from low- to high-risk gambling behaviour from time 1 to time 2 included male gender, tobacco use, older age, having less education, having friends who gamble and playing electronic gaming machines. CONCLUSIONS An increase in the intensity of gambling behaviour is associated with greater likelihood of future gambling related harm in adults.
Pathological gambling (PG) is an impulse control disorder with suggestive genetic vulnerability component. We evaluated the association of genetic variants in the dopaminergic receptor genes (DRD1-3s) with risk for gambling in healthy subjects using the Canadian Problem Gambling Index (CPGI). Healthy Caucasian subjects who had gambled at least once in their lifetime (n=242) were included in the analysis. Gender was not associated with the CPGI, while younger age was associated with higher CPGI scores. We have found that none of the single polymorphisms investigated on DRD1 and DRD3 were associated with CPGI scores in healthy subjects. However, we observed trends for association on the TaqIA/rs1800497 polymorphism (P=0.10) and the haplotype flanking DRD2 (G/C/A rs11604671/rs4938015/rs2303380; P=0.06). Both trends were associated with lower CPGI score. Our results provide further evidence for the role of dopamine D2-like receptor in addiction susceptibility.
The association between childhood maltreatment and gambling problems was examined in a community sample of men and women (N = 1,372). As hypothesized, individuals with gambling problems reported greater childhood maltreatment than individuals without gambling problems. Childhood maltreatment predicted severity of gambling problems and frequency of gambling even when other individual and social factors were controlled including symptoms of alcohol and other drug use disorders, family environment, psychological distress, and symptoms of antisocial disorder. In contrast to findings in treatment-seeking samples, women with gambling problems did not report greater maltreatment than men with gambling problems. These results underscore the need for both increased prevention of childhood maltreatment and increased sensitivity towards trauma issues in gambling treatment programs for men and women.
ABSTRACTPredictors of adolescent gambling behavior were examined in a sample of 436 males and females (ages 13–16). A biopsychosocial model was used to identify key variables that differentiate between non‐gambling and gambling adolescents. Logistic regression found that, as compared to adolescent male non‐gamblers, adolescent male gamblers were older, had more conflict in their family, were more likely to have used drugs, and have peers that gamble. Compared to adolescent female non‐gamblers, adolescent female gamblers had more attention and thought problems, and scored higher on rule‐breaking. For both males and females, religiosity was a protective factor against involvement in gambling. Some of the results are consistent with previous research, while some of these findings are unique to this study. These results shed light on factors to consider when developing programs to combat the negative impacts of gambling on adolescents.
Longitudinal research on the determinants of gambling behavior is sparse. This article briefly reviews the previous seventeen longitudinally designed studies, focusing on the methodology for each study. This is followed by a description of our ongoing longitudinal study entitled the Leisure, Lifestyle, and Lifecycle Project (LLLP). Participants for the LLLP were recruited from four locations in Alberta, Canada, including both rural and urban populations. In the LLLP most participants were recruited using random digit dialing (RDD), with 1808 participants from 5 age cohorts at baseline: 13-15, 18-20, 23-25, 43-45, and 63-65. Individuals completed telephone, computer, and face-to-face surveys at baseline, with the data collection occurring between February and October, 2006. At baseline, a wide variety of constructs were measured, including gambling behavior, substance use, psychopathology, intelligence, family environment, and internalizing and externalizing problems. Finally, the conclusions that can be drawn thus far are discussed as well as the plans for three future data collections.