Environmental correlates of gambling behavior in urban adolescents

Brief Virtual Workshop on Gambling Disorder to Raise Knowledge and Awareness Among Health Service Providers

Gambling disorder is a "hidden disease" due to the lack of visible markers. It often negatively affects multiple domains of a person's life and predicts adverse physical, mental, social, and financial outcomes. Health service settings are suited for early detection of gambling disorder because of its comorbid medical conditions and due to the trust patients have in their health service providers (HSPs). However, HSPs often lack the knowledge needed to screen for this disorder and to make appropriate referrals. This paper reports a quasi-experimental wait-list control study (experimental group n = 18; wait-list control group n = 14), with cross-over and a twelve-week follow-up which assessed whether a brief virtual gambling disorder training entitled Gambling Know More could improve gambling disorder knowledge among HSPs. Results showed workshop participation caused a significant increase in gambling disorder knowledge immediately after the workshop and twelve weeks later. Participation in Gambling Know More bodes well for increasing early detection of gambling disorder and appropriate treatment referrals among HSPs. Findings have important policy implications for the training of HSPs.

Gambling in children and adolescents

INTRODUCTION

Children are susceptible to problems with gambling because of developmental and cognitive immaturities, as well as a sensitivity to peer pressure and marketing.

SOURCES OF DATA

This review uses recent UK data from the Gambling Commission and from the Avon Longitudinal Study of Parents and Children, and evidence from recent reviews of gambling in children and adolescents.

AREAS OF AGREEMENT

The prevalence of gambling in children worldwide and in the UK is stable, having generally decreased since 2013. Online gambling is increasing in children and young people. A small minority of adolescents who gamble develop a gambling disorder. Adolescents who have problems with gambling tend to have lower self-esteem and a history of hyperactivity and impulsivity, are more likely to have parents who gamble, report less parental supervision and to use more alcohol than their peers.

AREAS OF CONTROVERSY

Children's access to slot machines, the relationship between gaming and gambling, and social media advertizing of gambling targeting children.

GROWING POINTS

An increase in online gambling and in-play sports betting by adolescents and the use of skins betting in video gaming.Areas timely for developing research: impact on young people of betting on e-gaming. How best to protect children from early exposure to gambling in the current internet age.

IMPLICATIONS FOR CLINICIANS

Need to be aware of the growing and complex phenomenon of gaming and gambling, and implications for the mental health of children and adolescents. The effective management of gambling disorders in children and adolescents requires close working with families.

Behavioral Intention to Gamble Among Adolescents: Differences Between Gamblers and Non-gamblers-Prevention Recommendations

Gambling is a rapidly growing phenomenon among adolescents associated with negative psychosocial effects. To prevent this public health problem, it is necessary to identify the factors that cause and maintain adolescent gambling. Based on the theory of planned behavior (TPB), structural equation models were used in a sample of 1174 adolescents (aged 12-20 years) to study the effect of attitudes, subjective norms and self-efficacy on gambling intention in adolescent gamblers (n = 432) and non-gamblers (n = 742). Measurement invariance was assessed and then structural model was tested separately in gamblers and non-gamblers. The influence of past gambling experience on the TPB model was also studied through multigroup analysis. All models showed adequate fit to the data. The relationships between attitudes and self-efficacy with gambling intention were significantly stronger in gamblers subsample. These results confirmed that gambling experience increases the predictive ability of the TPB model in gamblers. TPB independent variables explained 16.2% of variance of gambling intention in non-gamblers and 32.4% in gamblers. Subsequently, the TPB model for gamblers explained 19% of variance of gambling frequency. In this last model, gambling intention partially mediates the influence of self-efficacy on gambling behavior. The subjective norm was the variable with the greatest effect on gambling intention in non-gamblers, while self-efficacy to control gambling was the exogenous variable with greatest effect on gambling frequency. The findings suggest the possibility of specific gambling prevention in adolescent gamblers and non-gamblers.

'It's a tradition to go down to the pokies on your 18th birthday' - the normalisation of gambling for young women in Australia

OBJECTIVE

To understand the range of factors that may influence the normalisation of gambling for young women in Victoria, Australia.

METHODS

In-depth qualitative telephone interviews with 45 women aged 18-34 years.

RESULTS

Young women were exposed to gambling environments and some were gambling from an early age. Family members were the key facilitators of these activities. Once reaching the legal age of gambling, peers and boyfriends were instrumental in young women's gambling practices. Women attributed the normalisation of gambling to excessive marketing, feminised gambling environments, and the widespread availability of gambling in the community.

CONCLUSIONS

This study found several factors that influenced and encouraged young women to gamble, such as the feminisation of gambling products and environments, and determined that gambling is becoming a socio-culturally accepted activity for young women. Implications for public health: Researchers and policymakers should be increasingly focused on how different forms of gambling may be normalised for young women. Attention should be given to how young women may become a target market for the gambling industry, and how to implement strategies aimed at preventing any future potential harm posed by these industries and their marketing tactics and products.

Influence of Demographic and Psychological Factors on Attitudes Toward Sport Betting Among Young Adults in Southwest Nigeria

Prediction and wager on the outcome of games/matches are known as sports betting. Positive attitudes toward sports betting may, in the long run, predict sports betting behavior and gambling-related problems. This study, therefore, examined the influence of gender, age, sports betting knowledge and peer-based gambling on attitudes toward sports betting among young adults in Nigeria. The ex-post facto design was adopted in this cross-sectional survey. The participants were 749 students (42.9% females) of a large tertiary institution in southwest Nigeria. A standardized questionnaire comprising demographics and measures of attitudes toward sports betting, sports betting knowledge and perception of peer gambling behavior was utilized in the study. Results revealed that attitudes toward sports betting are positive for older males who are knowledgeable about sports betting and have friends who gamble. Sports betting knowledge and peer-based gambling stood out as significant predictors of attitudes toward sports betting. The social circles of young adults may be the starting points for initiatives to develop healthy attitudes toward sports betting and preventing gambling-related problems.

Immigrant status and problem-gambling severity in adolescents: Evidence for moderation by sensation seeking

Despite the multidimensional/ecological integrative perspective that suggests that the risk for problem gambling in adolescents can be determined by an interactive effect of different risk factors, few studies have investigated how different individual factors may affect the risk for problem gambling in a multiplicative way. This study aimed at exploring the interaction between immigrant status (IS) and sensation seeking (SS) on adolescent problem-gambling severity. The study involved 994 Italian adolescents (64% boys, M_age = 16.57, SD = 1.62). Participants' IS, SS and problem-gambling severity were individually assessed through, respectively, a socio-demographic questionnaire, the Brief Sensation Seeking Scale (BSSS) and the South Oaks Gambling Screen - Revised for Adolescents (SOGS-RA). Results showed that, among immigrant adolescents, there were higher levels of problem-gambling severity and a higher distribution of at-risk and problem gamblers with respect to non-immigrant adolescents. Both IS and SS had significant direct effects on problem-gambling severity, with IS and higher levels of SS being predictors of greater severity. A moderation analysis - controlling for gender and age - showed that adolescents with high scores of SS were more prone to experience gambling problems if they were also immigrant. These results have important implications for practice as they emphasize that specific interventions aimed at preventing problem gambling would be required for adolescents from immigrant families. In particular, it would be important to consider the role of SS in this specific youth target.

Gambling in adolescence: a narrative review of the last 20 years

BACKGROUND

Gambling has increasingly become a problem in adolescence over the last 20 years. Previous research has failed to identify exactly the level of involvement of adolescents in gambling, yet a relevant presence of addictive behaviors was noticed.

OBJECTIVE

This narrative review highlights the implications of adolescent gambling, taking into consideration the main risk and protection factors aimed at limiting gambling activity, as well as the main links with the impulse-control disorder, addiction, and behavioral addiction.

METHODS

The review process was conducted through Medline, Scopus, Web of Science and Google Scholar search engines. The considered keywords were "Gambling" AND "Adolescence," "Behavioral addiction," AND "Adolescence." The articles related to gambling and adolescence in the last 20 years were included in compliance with inclusion and exclusion criteria, to perform a consistent analysis of the phenomenon and the related maintenance factors.

RESULTS

Starting from 1067 articles, 107 were selected to denote the main thematic areas involved in the gambling problem. The online search was completed on December 13, 2019.

CONCLUSIONS

The narrative review of literature can facilitate the analysis of gambling problems in adolescence, as the main studies in the last 20 years showed the complexity of the problem, the links between addiction, and the most effective methods of prevention and treatment.

Gambling involvement and problem gambling correlates among European adolescents: results from the European Network for Addictive Behavior study

PURPOSE

Worldwide, concern has grown over the expansion of gambling among adolescents, who have an increased likelihood of developing risk-taking behaviors. This study aimed to increase knowledge of problem gambling among adolescents in seven European countries and to assess the effect of demographic and lifestyle factors recorded in the European Network for Addictive Behavior survey (https://www.eunetadb.eu).

METHODS

A cross-sectional school-based study (n = 13,284) was conducted in Germany, Greece, Iceland, The Netherlands, Poland, Romania and Spain. Anonymous self-completed questionnaires included socio-demographic data, internet usage characteristics, school achievement, parental control, the Internet Addiction Test, the South Oaks Gambling Screen-Revised for Adolescents Test and Achenbach's Youth Self-Report.

RESULTS

12.5% of the participants reported last year gambling activities either online or offline. 3.6% of the study participants and 28.1% of gamblers (either online or offline) were at risk or had a gambling problem. The study results showed that a higher proportion of adolescents was either at risk or had a gambling problem among males, in the older age group, when the parental educational level was lower/middle, and in the absence of siblings. Furthermore, being at risk or having a gambling problem was associated with lower age at first use of the internet, lower school grades, using the internet 6-7 days per week, and problematic internet use. At risk or problem gamblers had higher scores on all scales of problem behavior and lower scores (lower competence) on activities and academic performance.

CONCLUSIONS

Our findings underline the need for better gambling legislation and suggest the importance of developing social responsibility tools that may help diminish adolescent gambling involvement, with special attention to males.

The Effectiveness of the Game of Dice Task in Predicting At-Risk and Problem Gambling Among Adolescents: The Contribution of the Neural Networks

The Game of Dice Task (GDT; Brand et al. in Neuropsychology 19:267-277, 2005a; Psychiatry Res 133:91-99, 2005b) measures decision-making under objective risk conditions. Although disadvantageous decision-making has been shown in individuals with substance dependency, such as pathological dependency, any studies have been conducted with adolescents by using the GDT to investigate the relationship between the performance on the task and gambling behavior. Moreover, all the previous studies have considered only the GDT net score and not the single choices. In the current study, focusing on adolescents, we wanted to investigate the relationship between the sequence of the choices at the GDT and gambling behavior, measured with the SOGS-RA. To analyze the predictive power of the sequence of choices made in the GDT and problem gambling and gambling frequency, we used the Neural Networks (NNs), which are often used to find relationships between a series of input actions and the correspondent empirical outputs in order to discover behavioral patterns that may be predictive of at-risk behaviors. Results showed that neither a linear or a non-linear relationship could be detected between the GDT performance and the SOGS-RA classification both in terms of gambling problem severity and gambling frequency. Indeed, different training algorithms produced different performances of the NN on the training sets, but all of them showed a very low prediction capability on new samples. Thus, the performance at the GDT did not discriminate between adolescent gamblers with different and progressive levels of problematic gambling behavior and gambling frequency. Limitations and future studies are discussed.

Time Perspectives and Gambling in Adolescent Boys: Differential Effects of Present- and Future-Orientation

Adolescent boys are characterised by increased risk-taking behavior, including a relatively high propensity to develop problem gambling habits. The association between gambling and sensitivity to immediately available rewards is well-established, suggesting that gamblers are less influenced by potential future consequences than non-gamblers. Nevertheless, existing studies have considered present- and future-orientation as two ends of the same continuum, and have not investigated the possibility that present and future perspectives might make independent contributions to gambling behavior. In the current study, we adopted Zimbardo's multidimensional approach, which discriminates between not only present and future perspectives, but also between a hedonistic and fatalistic present-orientation (in addition to positive and negative orientations towards the past). The participants were 223 male adolescents (mean age = 16.7 years). We investigated the effects of time perspectives on gambling frequency and gambling problem severity, after taking into account the effects of age, sensation seeking, and gambling-related cognitive distortions. Gambling frequency was significantly predicted by the present fatalistic perspective, and problem gambling was significantly (negatively) related to the future perspective. The present hedonistic and past negative perspectives were also significantly related to both gambling frequency and gambling problems, although they did not explain additional variance in gambling behavior when the effects of the other factors were controlled. Overall, these results offer a fresh perspective on the role of time perspectives in gambling behavior, with potential implications for understanding the origins of gambling problems and the development of novel interventions.

Problematic Online Betting Among Turkish Adolescents

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.

Relationships Between Perceived Family Gambling and Peer Gambling and Adolescent Problem Gambling and Binge-Drinking

The study systematically examined the relative relationships between perceived family and peer gambling and adolescent at-risk/problem gambling and binge-drinking. It also determined the likelihood of at-risk/problem gambling and binge-drinking as a function of the number of different social groups with perceived gambling. A multi-site high-school survey assessed gambling, alcohol use, presence of perceived excessive peer gambling (peer excess-PE), and family gambling prompting concern (family concern-FC) in 2750 high-school students. Adolescents were separately stratified into: (1) low-risk, at-risk, and problem/pathological gambling groups; and, (2) non-binge-drinking, low-frequency-binge-drinking, and high-frequency-binge-drinking groups. Multinomial logistic regression showed that relative to each other, FC and PE were associated with greater likelihoods of at-risk and problem/pathological gambling. However, only FC was associated with binge-drinking. Logistic regression revealed that adolescents who endorsed either FC or PE alone, compared to no endorsement, were more likely to have at-risk and problem/pathological gambling, relative to low-risk gambling. Adolescents who endorsed both FC and PE, compared to PE alone, were more likely to have problem/pathological gambling relative to low-risk and at-risk gambling. Relative to non-binge-drinking adolescents, those who endorsed both FC and PE were more likely to have low- and high-frequency-binge-drinking compared to FC alone or PE alone, respectively. Family and peer gambling individually contribute to adolescent at-risk/problem gambling and binge-drinking. Strategies that target adolescents as well as their closely affiliated family and peer members may be an important step towards prevention of harm-associated levels of gambling and alcohol use in youths.

Gambling-Related Distortions and Problem Gambling in Adolescents: A Model to Explain Mechanisms and Develop Interventions

Although a number of gambling preventive initiatives have been realized with adolescents, many of them have been developed in absence of a clear and explicitly described theoretical model. The present work was aimed to analyze the adequacy of a model to explain gambling behavior referring to gambling-related cognitive distortions (Study 1), and to verify the effectiveness of a preventive intervention developed on the basis of this model (Study 2). Following dual-process theories on cognitive functioning, in Study 1 we tested a model in which mindware gap, i.e., susceptibility to the gambler's fallacy, and contaminated mindware, i.e., superstitious thinking, were the antecedents of gambling-related cognitive distortions that, in turn, affect gambling frequency and problem gambling. Participants were 306 male adolescents (Mage = 17.2 years). A path analysis indicated that cognitive distortions have a mediating role in the relationship that links probabilistic reasoning fallacy and superstitious thinking with problem gambling. Following these findings, in Study 2 we developed a school-based intervention aimed to reduce gambling-related cognitive distortions acting on the above cited mindware problems. A pre- and post-test design - with a 6 months follow-up - was performed with 34 male adolescents (Mage = 16.8), randomly assigned to two groups (Training and No Training), and their baseline equivalence was verified. A Mixed 2 × 2 ANOVA attested a significant Time X Group interaction, indicating a significant reduction of the cognitive distortions from pre-test to post-test only in the Training group. The follow-up attested to the stability of the training effects and the reduction of gambling frequency over time. These findings suggest that prevention strategies should address mindware problems, which can be considered as predictors of gambling-related cognitive distortions.

Adolescent Gambling-Oriented Attitudes Mediate the Relationship Between Perceived Parental Knowledge and Adolescent Gambling: Implications for Prevention

Although substantial research has provided support for the association between parental practices and adolescent gambling, less is known about the role of adolescent attitudes in this relationship. The primary purpose of this study was to test an integrative model linking perceived parental knowledge (children's perceptions of their parents' knowledge of their whereabouts and companions) with adolescent gambling while evaluating the mediating effects of adolescents' own gambling approval, risk perception of gambling, and descriptive norms on gambling shared with friends. The data were drawn from the ESPAD® Italia 2012 (European School Survey Project on Alcohol and Other Drugs) study, which is based on a nationally representative sample of Italian adolescent students aged 15-19. The analysis was carried out on a subsample of 19,573 subjects (average age 17.11, 54 % girls). Self-completed questionnaires were administered in the classroom setting. The results revealed that adolescents who perceived higher levels of parental knowledge were more likely to disapprove of gambling and show higher awareness of its harmfulness, which were in turn negatively related to gambling frequency. They were also less likely to perceive their friends as gamblers, which was also negatively related to gambling frequency. These findings suggest that gambling prevention efforts should consider perceived parental knowledge and gambling-oriented attitudes (self-approval, risk perception, and descriptive norms) as factors that may buffer adolescent gambling behavior in various situations.

Income Inequality and Adolescent Gambling Severity: Findings from a Large-Scale Italian Representative Survey

Background: Studies have shown that problems related to adult gambling have a geographical and social gradient. For instance, adults experiencing gambling-related harms live in areas of greater deprivation; are unemployed, and have lower income. However, little is known about the impact of socioeconomic inequalities on adolescent problem gambling. The main purpose of the present study was to investigate the contextual influences of income inequality on at-risk or problem gambling (ARPG) in a large-scale nationally representative sample of Italian adolescents. A secondary aim was to analyze the association between perceived social support (from family, peers, teachers, and classmates) and ARPG. Methods: Data from the 2013-2014 Health Behavior in School-aged Children Survey (HBSC) Study was used for cross-sectional analyses of ARPG. A total of 20,791 15-year-old students completed self-administered questionnaires. Region-level data on income inequality (GINI index) and overall wealth (GDP per capita) were retrieved from the National Institute of Statistics (Istat). The data were analyzed using the multi-level logistic regression analysis, with students at the first level and regions at the second level. Results: The study demonstrated a North-South gradient for the prevalence of ARPG, with higher prevalence of ARPG in the Southern/Islands/Central Regions (e.g., 11% in Sicily) than in Northern Italy (e.g., 2% in Aosta Valley). Students in regions of high-income inequality were significantly more likely than those in regions of low-income inequality to be at-risk or problem gamblers (following adjustment for sex, family structure, family affluence, perceived social support, and regionale wealth). Additionally, perceived social support from parents and teachers were negatively related to ARPG. Conclusions: Income inequality may have a contextual influence on ARPG. More specifically, living in regions of highest income inequality appeared to be a potential factor that increases the likelihood of becoming an at-risk or problem gambler. Findings of the study suggest that wealth distribution within societies affected by economic policies may indirectly have an influence adolescent gambling behaviors.

Macau parents' perceptions of underage children's gambling involvement

Objectives

The study examined Macau parents’ perceptions of underage children’s gambling involvement, and parents’ attitudes towards help seeking if their children had a gambling problem. The parents’ gambling behavior in the past year was also investigated.

Methods

This is a parent survey using a self-administered questionnaire. A convenience sample of 311 Macau parents (106 fathers and 205 mothers) with underage children aged 3–17 years was recruited. The response rate is 77.8%. The participants were asked if they had ever approved or taught their underage children to gamble, and how did they award their children when they won in gambling games. The parents were also asked if they had gambled in the previous 12 months, and their gambling behavior was assessed by the Chinese Problem Gambling Severity Index (CPGSI).

Results

Half of the parents surveyed (52%) did not approve underage gambling but 81% taught their underage children to play different gambling games. Children were awarded with money (55%), praises (17.5%), toys (15%) and food (12.5%) when they won in games. One-fifth (20.6%) were distressed with their children’s gambling problem. Many (68.8%) were willing to seek help to cope with children’s gambling problems. Only 21.2% (n = 66) of the parents reported gambling in the past year. Using the CPGSI, 4.5% of these gamblers could be identified as problem gamblers, and 16.7% were moderate-risk gamblers.

Conclusion

The study results indicate parent education should be included in prevention of underage gambling.

Is Medicine Use for Nervousness Associated with Adolescent At-Risk or Problem Gambling?

OBJECTIVE

To examine the association between adolescent at-risk or problem gambling (ARPG) and medicine used to treat nervousness in a large-scale nationally representative sample of Italian adolescents.

STUDY DESIGN

Data from the 2013/2014 Health Behaviour in School-aged Children Survey was used for cross-sectional analyses (a sample of 20,791 15-year-old students). Self-administered questionnaires were completed by a representative sample of high-school students. Respondents' ARPG, use of medicine for nervousness and potential confounding factors were assessed. Multilevel logistic regression analyses were used to test the association between medicine use to treat nervousness and ARPG.

RESULTS

The overall prevalence of adolescents reporting medicine use for nervousness in the last month was 6.3%. The odds of ARPG were 3 times higher among adolescents who used medicine for nervousness compared to that among adolescents who did not take such medicine (OR 2.96, 95% CI 2.07-4.25). Importantly, the association between medicine used to treat nervousness and ARPG did not vary significantly when viewed in light of psychological symptoms.

CONCLUSIONS

Medicine use to treat nervousness is associated with increased risk of gambling-related harm.

Proactive coping and gambling disorder among young men

Objectives Male sex, young age, and frequent gambling are considered as risk factors for gambling disorder (GD) and stress might be one of the triggers of gambling behavior among problem gamblers. Conversely, well-developed coping with stress might counteract gambling problems. The Proactive Coping Theory provides a promising approach for the further development of preventive and treatment measures. The objective of the study was to investigate different facets of proactive coping (PC) in young male gamblers. Methods Young men from Bavaria were recruited via the Munich citizens' registry (n = 2,588) and Facebook invitations (n = 105). In total, 173 out of 398 individuals were positively screened for frequent gambling and/or signs of related problems and completed the baseline questionnaire of the Munich Leisure-time Study. Factors investigated include gambling problems, PC, impulsiveness, social support, and psychological distress. Results Gambling problems were associated with lower levels of preventive coping as well as of adaptive reaction delay. The associations were also significant when controlled for impulsiveness and general psychological distress. Preventive coping moderated the association between social support and gambling problems. Discussion and conclusions Young men with gambling problems less frequently prevent the occurrence of stressors and more often react hasty when these occur. While the investigated group reported good social support, this factor was negatively associated with GD only among individuals with good preventive coping. Preventive coping poses a useful construct for selective prevention and treatment as it can be modified in professional interventions.

"I Am Becoming More and More Like My Eldest Brother!": The Relationship Between Older Siblings, Adolescent Gambling Severity, and the Attenuating Role of Parents in a Large-Scale Nationally Representative Survey Study

The present study examined the association between having older siblings who gamble and adolescent at-risk/problem gambling and how parents (i.e., parental knowledge of their whereabouts) and peers might moderate such effects. Data were drawn from the ESPAD^®Italia2012 survey (European School Survey Project on Alcohol and Other Drugs) comprising a nationally representative Italian sample of adolescents. The analysis was carried out on a subsample of 10,063 Italian students aged 15-19 years (average age = 17.10; 55 % girls) who had at least one older sibling and who had gambled at some point in their lives. Respondents' problem gambling severity, older gambler sibling, gambler peers, parental knowledge, and socio-demographic characteristics were individually assessed. Multinomial logistic regression analyses including two- and three-way interactions were conducted. The odds of being an at-risk/problem gambler were higher among high school students with older siblings that gambled and those with peers who gambled. Higher parental knowledge (of who the adolescent was with and where they were in their leisure time) was associated with lower rates of at-risk/problem gambling. There was also an interaction between gamblers with older siblings and parental knowledge. The combination of having siblings who gambled and a greater level of parental knowledge was associated with lower levels of problem gambling. The present study confirmed the occurrence of social risk processes (older siblings and peers who gambled) and demonstrated that gambling among older siblings and peers represents an important contextual factor for increased at-risk/problem gambling. However, parental knowledge appears to be sufficient to counterbalance the influence of older siblings.

Gambling Outcome Expectancies and Gambling Behavior Among African-American Adolescents: Gender as a Moderating Variable

Most high school adolescents have reported past year gambling, and males gamble more frequently and problematically than females. Ethnic minority adolescents appear to be gambling at a higher rate than Caucasian adolescents. There is evidence indicating that adolescent gambling outcome expectancies are correlated with gambling behavior, but limited evidence that this relation differs by gender. In the present study gender was evaluated as a moderator in the relation between gambling outcome expectancies and gambling behaviors in an African-American high school sample. Males gambled more frequently, gambled more problematically and held more positive gambling outcome expectancies than females. Gender was found to moderate the relations between gambling frequency and the expectations of material gain, affect, self-evaluation and parental approval. Gender also moderated the relations between gambling problems and expectations of affect and self-evaluation. These findings should inform future adolescent gambling prevention and intervention programs.

Gambling Disorder and Minority Populations: Prevalence and Risk Factors

PURPOSE OF REVIEW

Previous studies demonstrate disparities in health and health services including gambling disorders (GD) among ethnic and racial minority groups. In this review, we summarize studies examining the prevalence of GD across different ethnic and racial minorities.

RECENT FINDINGS

We describe the sociodemographic subgroup variations at heightened risk for GD and factors associated with GD in racial and ethnic minority groups including gambling availability, comorbid substance use, psychiatric conditions, stress, acculturation, and differences in cultural values and cognitions. We found that research of GD among minority groups is scant, and the prevalence of GD among these groups is at a magnitude of concern.

SUMMARY

Racial and ethnic minority status in it of itself is not a risk factor for GD but may be a proxy for underlying potential risk factors. The need for prevention and treatment programs for different cultural group remains unmet.

« La première fois que j’ai joué… » : l’expérience d’adolescents considérés comme ayant des difficultés avec les jeux de hasard et d’argent

This study describes the initial gambling experiences of teenagers who have developed problem gambling habits with regard to: a) the nature of the gambling activities, b) the significance of the first experience in terms of the benefits and attractive aspects of gambling, and c) the progression toward the development of problematic behaviours. The research design draws on secondary analysis of data from semi-structured interviews carried out with 31 adolescents with problem gambling behaviours in treatment for the consumption of psychoactive substances (PS). An analysis of the teenagers' responses reveals the existence of material, emotive and social benefits associated with their first gambling experience and the exacerbation of their behaviours. The results were analysed in light of the teenagers' social context: popularity of certain games, importance of performance, wealth and the pursuit of pleasure.

Prevalence and Correlates of Problem Gambling in a Representative Sample of Norwegian 17-Year-Olds

We report data collected in a representative sample of 17-year-old Norwegians to investigate prevalence rates of non-problem, risk, and problem gambling, as measured by the Problem Gambling Severity Index (PGSI). In addition, we explored the importance of demographic, personality, motivational, social, and health variables explaining variance in adolescent gambling. Prevalence rates of risk and problem gambling were low but similar to those found in previous studies outside of Norway using the PGSI in adolescent samples. With regard to the relative importance of the various covariates, we found that motivational variables (future gambling intentions, attitudes toward gambling, and gambling-related knowledge) distinguished best between those who did not gamble, non-problem gamblers, and risk and problem gamblers. Furthermore, social variables were important covariates of adolescent gambling; significant associations were found for family and friends' approval of gambling, parental monitoring, father's level of education, and having relatives or friends with a history of a gambling disorder. We discuss possible reasons for differences between the covariates with regard to their importance for explaining adolescent gambling and address implications for future research.

At-risk and problem gambling among adolescents: a convenience sample of first-year junior high school students in Finland

Background

Adolescent gambling and substance use are viewed as a public health concern internationally. The early onset age of gambling is a known risk factor for developing gambling problems later in life. The aims of this study are: to evaluate the internal consistency reliability, factorial validity and classification accuracy of the Finnish version of DSM-IV-Multiple Response-Juvenile (DSM-IV-MR-J) criteria measuring at-risk/problem gambling (ARPG); to examine gender differences in gambling participation, ARPG and substance use among first-year junior high school students; and to investigate the association of gambling and gaming (video game playing) participation, substance use and social variables with ARPG.

Methods

This study examined 988 adolescents (mean age 13.4 years) at 11 public schools in Finland between October-December 2013. The response rate was 91.6%. Chi-squared test and binary logistic regression analysis were used.

Results

‘Illegal acts’ was the most endorsed and sensitive, but the least specific criteria identifying ARPG. During the past year, 51.6% of the respondents had gambled, 7.9% were identified as at-risk/problem gamblers (DSM-IV-MR-J score ≥ 2), 8.0% had smoked and 8.9% had been drinking for intoxication, and the first three were significantly more common among boys than girls. The odds ratio of being a male past-year at-risk/problem gambler was 2.27, 5.78 for gambling often or sometimes, 2.42 for video game playing weekly or more often and 6.23 for having peer gamblers.

Conclusions

Overall, the Finnish version of the DSM-IV-MR-J had acceptable internal consistency reliability and factorial validity. None of the DSM-IV-MR-J criteria were accurate enough to screen ARPG per se. ARPG past-year prevalence was relatively high with males gambling more than females. ARPG was as common as drinking alcohol for intoxication and smoking. Peer gambling was strongly associated with ARPG. Efficient strategies to minimise the risks of gambling problems, tools for prevention and identification of ARPG among the underage are needed.

Self-identification as a moderator of the relationship between gambling-related perceived norms and gambling behavior

This research was designed to evaluate social influences and perceived social norms on gambling behavior among undergraduate students. Furthermore, this research was designed to replicate and extend previous research demonstrating that young adults overestimate the prevalence of gambling among peers, and that the magnitude of overestimation is positively associated with own use (Larimer and Neighbors, Psychol Addict Behav 17:235-243, 2003). We expected that; (1) gambling college students would identify more strongly with other gambling students compared to other students in general; (2) identification with other gambling students would predict gambling behaviors over and above perceived prevalence of gambling; and (3) identification with other gambling students would moderate the association between perceived social norms and gambling behavior. Participants included 1,486 undergraduate students who completed measures assessing gambling quantity and frequency, gambling-related perceived descriptive norms, and identification with groups. Results revealed that perceived norms for gambling were associated with gambling and revealed that students identified more strongly with other students than either gamblers or student gamblers. However, gambling behavior was more strongly associated with identification with gambling students than students in general. There was consistent support for the perspective that social identity moderates the association between perceived norms for gambling and gambling behavior. This research builds on previous examinations of social influences related to gambling and suggests that it may be important to consider the overall prevalence of a given behavior before considering norms-based intervention approaches. Interventions utilizing social norms for gambling may be advised to consider references other than just the typical student.

Differences in gambling problem severity and gambling and health/functioning characteristics among Asian-American and Caucasian high-school students

Studies of Asian-American adults have found high estimates of problematic gambling. However, little is known about gambling behaviors and associated measures among Asian-American adolescents. This study examined gambling perceptions and behaviors and health/functioning characteristics stratified by problem-gambling severity and Asian-American and Caucasian race using cross-sectional survey data of 121 Asian-American and 1659 Caucasian high-school students. Asian-American and Caucasian adolescents significantly differed on problem-gambling severity, with Asian-American adolescents more often reporting not gambling (24.8% vs. 16.4%), but when they did report gambling, they showed higher levels of at-risk/problem gambling (30.6% vs. 26.4%). Parental approval or disapproval of adolescent gambling also significantly differed between races, with Asian-American adolescents more likely to perceive both parental disapproval (50.0% vs. 38.2%) and approval (19.3% vs. 9.6%) of gambling. Asian-American adolescents were also more likely to express concern about gambling among close family members (25.2% vs. 11.6%). Among Asian-American adolescents, stronger associations were observed between at-risk/problem gambling and smoking cigarettes (interaction odds ratio=12.6). In summary, differences in problem-gambling severity and gambling perceptions indicate possible cultural differences in familial attitudes towards gambling. Stronger links between cigarette smoking and risky/problematic gambling amongst Asian-American adolescents suggest that prevention and treatment efforts targeting youth addictions consider cultural differences.

Impulsivity trajectories and gambling in adolescence among urban male youth

AIM

Building on the recent emerging literature on the impulsivity trajectory-gambling association, this study investigated the association between developmental trajectories of teacher-rated impulsivity in early adolescence (ages 11-15 years) and subsequent gambling and gambling problems (i.e. at-risk and problem gambling) by age 19.

DESIGN

Prospective cohort design.

SETTING

Urban communities in Baltimore, Maryland.

PARTICIPANTS

The sample consists of 310 predominately minority (87%) and low socio-economic status (SES) (70%) males followed from first grade to late adolescence.

MEASUREMENTS

Impulsivity was measured using teacher ratings of classroom behavior. Self-reported gambling behavior was assessed using the South Oaks Gambling Screen-Revised for Adolescents (SOGS-RA).

FINDINGS

Results from a conventional growth model suggest that the intercept of the impulsivity development (as measured by the repeated assessments of impulsivity across the entire developmental period) was associated significantly with gambling. Results from a general growth mixture model evidenced two distinct trajectories: a high impulsivity trajectory (41% of the sample) and a low impulsivity trajectory (59% of the sample). Despite its non-significant association with any gambling, heterogeneity in impulsivity development was associated significantly with gambling problems. Specifically, being in the high impulsivity trajectory doubled the odds of meeting criteria for at-risk or problem gambling [odds ratio (OR) = 2.09, 95% confidence interval (CI): 1.02, 4.27)] and tripled the odds of meeting criteria for problem gambling (OR = 2.84, 95% CI: 1.02, 7.91).

CONCLUSIONS

Development in impulsivity is associated strongly with problem/at-risk gambling in adolescence among urban male youth. Findings highlight the importance of distinguishing gambling problems from any gambling when evaluating programs aimed at reducing youth gambling problems through reducing impulsivity.

Youth aggressive/disruptive behavior trajectories and subsequent gambling among urban male youth

This study examines the association between aggressive/disruptive behavior development in two distinct developmental periods-childhood (i.e., Grades 1-3) and early adolescence (i.e., Grades 6-10)-and subsequent gambling behavior in late adolescence up to age 20. The sample consists of 310 urban males of predominately minority and low socioeconomic status followed from first grade to late adolescence. Separate general growth mixture models were estimated to explore the heterogeneity in aggressive/disruptive behavior development in the aforementioned two periods. Three distinct behavior trajectories were identified for each period: a chronic high, a moderate increasing, and a low increasing class for childhood, and a chronic high, a moderate increasing, followed by decreasing and a low stable class for early adolescence. There was no association between childhood behavior trajectories and gambling involvement. Males with a moderate behavior trajectory in adolescence where two times more likely to gamble compared to those in the low stable class (OR = 1.89, 95% CI = 1.11, 3.24). Those with chronic high trajectories during either childhood or early adolescence (OR = 2.60, 95% CI = 1.06, 6.38; OR = 3.19, 95% CI = 1.18, 8.64, respectively) were more likely to be at-risk/problem gamblers than those in the low class. Aggressive/disruptive behavior development in childhood and early adolescence is associated with gambling and gambling problems in late adolescence among urban male youth. Preventing childhood and youth aggressive/disruptive behavior may be effective to prevent youth problem gambling.

Intergenerational transmission of gambling: links between young adult and perceived grandparent gambling attitudes and behavior

This study examined associations between the gambling attitudes and behavior of 213 young adults and their perceptions of the gambling attitudes and behavior of their closest grandparent. Regression analyses showed that young adult gambling attitudes mediated the relations between perceived grandparent gambling attitudes and behavior and young adult gambling behavior. Grandparent-grandchild relationship quality experienced while growing up did not moderate the relations between young adult and perceived grandparent gambling attitudes and behavior. Men experienced gambling at a younger age and reported more positive gambling attitudes, more frequent gambling activity, higher levels of gambling pathology, and higher levels of gambling affinity than women. Implications of results and suggestions for future research are discussed.

Association between internet gambling and problematic internet use among adolescents

The study objectives were to evaluate the correlates and psychosocial implications of internet gambling among adolescents, as well as the association between internet gambling and problematic internet use. A cross-sectional study design was applied among a random sample (N = 484) of adolescents (71.2% boys; 28.8% girls; mean age ± standard deviation, SD = 14.88 ± 0.55 years). Self-completed questionnaires, including internet gambling practices, internet use characteristics, Young Internet Addiction Test, and Strengths and Difficulties Questionnaire were utilized. The prevalence of internet gambling was 15.1%. Internet gambling was associated with psychosocial maladjustment, including Abnormal Conduct Problems (gender adjusted odds ratio, AOR = 3.83; 95% confidence interval, 95% CI: 1.86-7.92) and Borderline Peer Problems (AOR = 2.04; 95% CI: 1.09-3.85). The likelihood of concomitant problematic internet use was significantly higher among internet gamblers (AOR = 1.81; 95% CI: 1.03-3.19). Multivariate regression analyses indicated that among all characteristics of internet use assessed, utilizing the internet for the purposes of gambling practices was independently associated with problematic internet use among adolescents (AOR = 3.43; 95% CI: 1.40-8.39). Thus, the study findings suggest that adolescents who participate in internet gambling practices are more likely to concomitantly present with problematic internet use.

Family influences on adolescent gambling behavior: a review of the literature

Gambling, and gambling related problems, are recognized as an emerging health issue among adolescents. Adolescent gambling is associated with numerous individual, social, and family characteristics. This paper provides a review of 21 empirical studies published between 1997 and 2008 that examine family influences on adolescent gambling behavior. Family influences on gambling behavior are conceptualized in the following five domains: (1) family sociodemographic factors, (2) general family climate, (3) family members' attitudes and behaviors, (4) parenting practices, and (5) family relationship characteristics. Based on the review of extant literature, there is empirical evidence that family characteristics are associated with adolescent gambling and further examination of family system influences on gambling behavior is needed. Gaps in the current literature and recommendations for future research are discussed to help inform the study of family influences on adolescent gambling behavior.

Correlates of gambling among youth in an inner-city emergency department

Correlates of past year gambling were examined in a diverse sample of 1128 youth ages 14 to 18 (54.1% female, 58.0% African American) presenting to an inner-city emergency department (ED). Overall, 22.5% of the sample reported past-year gambling. Male youth were more likely to gamble than female youth, and African American youth reported higher rates of past-year gambling than non-African American youth. Significant bivariate correlates of gambling included lower academic achievement, being out of school, working more than 20 hours per week, alcohol, cigarette, and marijuana use, alcohol problems, severe dating violence, moderate and severe general violence, and carrying a weapon. When examined simultaneously, being male, African American, out of school, working for pay, alcohol and marijuana use, severe general violence, and carrying a weapon all emerged as significant correlates of past-year gambling, largest amount of money gambled, and gambling frequency. In addition, involvement in severe dating violence was associated with frequency and largest amount gambled. The results suggest that gambling is common among youth in the inner city and is associated with several risk behaviors. The inner-city ED may provide a context for screening and intervention to address multiple risk behaviors. (PsycINFO Database Record (c) 2009 APA, all rights reserved).

Gender differences in mental health characteristics and gambling among African-American adolescent gamblers

This study explores gender differences in lifetime and recent substance use/internalizing behavior, childhood externalizing behavior, and gambling preferences among African-American youth gamblers. Data are from a prospective study of a community sample of 452 urban African-American youths who began at entry into first grade and were followed for ten years. Gambling was associated with high teacher ratings of childhood externalizing behaviors among males and with high parent ratings of childhood impulsivity and hyperactivity among both genders. Internalizing behavior was associated with female gambling. No male-female differences in substance use/lifetime conduct disorder among gamblers were noted. Gambling preferences/frequency differed across genders.