Adam Goodie, Ph.D.

What is a “social network analysis” of gambling disorders and responsible gaming? The phrase might evoke images of Mark Zuckerberg in a hooded sweatshirt, or the Oscar-winning film about the creation of Facebook. In reality, a social network analysis (SNA) is a method that researchers use to study how social connections effect behaviors, such as problem or pathological gambling.

“It’s important to realize that this research relates to the naturally occurring social networks that we all have with people we actually know, and not in particular to social technologies like Facebook or Twitter,” said Dr. Adam Goodie, an associate professor at the University of Georgia and director of the Georgia Decisions Lab.

Dr. Goodie and his team recently received a $172,000 grant from the NCRG to study how social connections may impact an individual’s gambling behavior. How do researchers in this field study something as intangible as social connections? “There are two basic approaches,” said Dr. Goodie. “In an ‘egocentric’ type of study, each participant reports on his or her own personalnetwork, and there is no assumption that any two participants know each other.”

The other type is a “sociocentric” analysis, which studies all members of an existing social structure and examines the many relationships and bonds that influence the members’ perspectives and behaviors. The team at University of Georgia will take an “egocentric” approach to learning about the lives and gambling behaviors of nearly 250 frequent gamblers and their 30 closest social connections, a project that will produce information on more than 7,000 people.

Dr. Goodie’s team will evaluate a gambler’s social networks on two major characteristics: “density” and “centrality.” Density is the degree to which members of your network know other members. In this case, the more that people in a network know each other, the “denser” the network. “Centrality” describes the degree to which a person in a given network has connections with others in that same social circle, often becoming a person of influence. (e.g., a spouse who knows almost all of your social contacts would have high centrality).

By using these metrics, the researchers will measure how problematic gambling behavior impacts the relationships of those surrounding the individual who has been diagnosed with pathological gambling. For relatively simple relationships between the gambling behavior of an individual and their peers, the social network analysis may show something completely different than more complex relationships, depending on how close or “dense” the social network of a pathological gambler is when compared with non-gambling situations. The researchers also will be looking at how an individual’s problematic gambling behavior correlates with other potential disorders, such as substance abuse. “We know that problem gamblers tend to have these traits themselves,” said Dr. Goodie, “and we are exploring whether their entire networks might possess these traits to a greater degree than nonproblem gamblers.”

Once Dr. Goodie and his team have more insight into the relationships between social networks and gambling behavior, those findings will allow them to ask additional questions about how these research findings translate to realworld relationships. Though the proposed research hopes to shed light on how social factors contribute to gambling behavior, there is still plenty of research to be done on individual factors such as personality traits and brain chemistry. “As is so often the case in the real world, finding that one factor has a causal role usually doesn’t rule out the possibility that other factors also play roles.” Dr. Goodie said.

This profile of NCRG-funded researcher Dr. Adam Goodie, associate professor at the University of Georgia, was originally published in the summer 2012 edition of Responsible Gaming Quarterly. To read or download a full copy of this issue, you can visit theNCRG website.

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Responsible Gaming Education Week isn’t the only time of year that the National Center for Responsible Gaming (NCRG) and the American Gaming Association (AGA) work together to help educate community members on some of the latest research and information about how to gamble responsibly. They also produceResponsible Gaming Quarterly,a free publication that provides a broad range of coverage on recent research results, regulatory efforts, studies and developments in the treatment field and best practices for programs that encourage responsible gaming.

In its ninth year of publication, the NCRG and AGA relaunchedResponsible Gaming Quarterlyas a fully online publication for the summer 2012 issue. You can visit the AGA or the NCRG’s website to see the full issue and flip through the pages!

The summer 2012 issue includes articles that highlight:

  • Events such as Responsible Gaming Education Week and the 13thannual NCRG Conference on Gambling and Addiction
  • International responsible gaming programs, including a new mobile app in Canada and online initiatives in Singapore.
  • Back-to-school programs from both the NCRG and the Problem Gambling Council of Colorado that are educating students about gambling problems and the legal age to play.
  • NCRG-funded research that examines the social networks of those with gambling disorders.
  • And more!

Do you have a story idea for the nextResponsible Gaming Quarterly? Please let us know in the comments below.

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Even though Responsible Gaming Education Week only happens once a year, the American Gaming Association (AGA) and the National Center for Responsible Gaming (NCRG) focuses on responsible gaming year-round through programs and education initiatives. As in past years, the NCRG is joining with the AGA to encourage casinos and their patrons to understand how to gamble responsibly for Responsible Gaming Education Week, July 30 to August 3. During this year’s Responsible Gaming Education Week, we’ll use Gambling Disorders 360 to highlight some of the NCRG’s responsible gaming resources, as well as successful tools from other groups.

The NCRG believes that education is an essential component of increasing awareness of gambling disorders and promoting responsible gaming. There are two key NCRG programs that are used to develop and enhance responsible gaming programs in the gaming industry. ThePartnership for Excellence in Education and Responsible Gaming (PEER)program is a dynamic, one-of-a-kind program created by the NCRG to provide the tools and resources needed to develop a comprehensive and world-class responsible gaming program.EMERGE,which stands fortheExecutive, Management and Employee Responsible Gaming Educationprogram, is a science-based online training program for gaming industry employees, but can be used by everyone.

PEERwas created to help gaming organizations create a comprehensive responsible gaming education program rooted in sound science but practical and understandable for all employees and patrons. A codified approach to responsible gaming is vital for success, but not everyone has the necessary resources to implement a comprehensive program. This is wherePEERcomes into play. The program was based on theNCRG’s Code of Conduct for Responsible Gamingand membership inPEERprovides organizations full access to thePEERResource Guide, a blueprint for developing and implementing a world-class gaming education program, regardless of the size of the gaming facility.

A key component ofPEERisEMERGE,the NCRG’s web-based training program developed by addiction specialists at Harvard Medical School.EMERGEis customizable to any gaming facility and translates the most current scientific research on gambling disorders into a practical tool for casino employees at all member casinos. Current casinos who are usingEMERGEinclude San Manuel Band of Mission Indians in California and Dooley’s Club of Australia. In fact, in the spring of 2010,Tribal Government Gamingmagazine featured an article about the responsible gaming measures already in place at tribal casinos and how some of these operations, including San Manuel Band of Mission Indians, have expanded their efforts to include science-based technological innovations, such asEMERGE.

You can view the introductory video forEMERGEbelow to learn more about how the program works. For more information onPEERorEMERGE, contact Amy Martin at (202) 552-2689 or visit www.ncrg.org/peerprogram. Please feel free to let us know your thoughts in the comments section below.

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Gambling disorders and responsible gaming aren’t just casino issues – they’re community issues. From local companies and nonprofit organizations to government officials and civic leaders, everyone in the community has a role to play in getting educated and helping to spread the word about available resources. To help educate various stakeholders about this community issue, the National Center for Responsible Gaming (NCRG) developed theGambling and Healthseries, including guidebooks and factsheets that are designed to explain more about pathological gambling, provide resources available to refer to those who may need help and encourage responsible decisions when gambling.

During this year’sResponsible Gaming Education Week, the NCRG is launching the first edition of theGambling and Healthseries, titled “Gambling and Health in the Workplace.” Human resources (HR) and employee assistance (EA) professionals are often trained to help employees with addiction and other mental health issues, but are not always equipped with the knowledge and resources when it comes to pathological gambling. To help address this issue, the NCRG created this educational resource to help HR and EA managers learn about gambling disorders, encourage responsible decisions when gambling and understand practical ways to assist and refer individuals with gambling problems.

The guide provides the latest research on gambling disorders, frequently asked questions that HR and EA professionals might face in the workplace, characteristics of pathological gambling that they may see in an employee’s behavior and ways to help educate employees about responsible gaming. Additionally, there is a one-page flyer for employees that outlines facts about the issue and resources to learn more about gambling addiction. The guide and one-pager are available as free downloads atwww.ncrg.org/gamblingandhealth.

‘Gambling and Health in the Workplace’ was developed under the guidance of an advisory committee of leaders in the HR and EA fields, drawing experience from government, the commercial gaming industry and mental health clinicians. It is being released in conjunction with Responsible Gaming Education Week, an annual program coordinated by the American Gaming Association and the National Center for Responsible Gaming designed to provide gaming companies and affiliated national organizations with an opportunity to expand on work they do every day to educate employees and patrons about gambling disorders and how to gamble responsibly.

For more information or to download a free copy of the guidebook, visitwww.ncrg.org/gamblingandhealth. Stay tuned to Gambling Disorders 360˚ for more information on Responsible Gaming Education Week activities, newly available resources and successful responsible gaming programs.

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Deadline to apply: Friday, July 20

The NCRG is thrilled to announce that need-based scholarships are now available to help offset the cost of attending the13th annual NCRG Conference on Gambling and Addiction. This year, based on response and availability, the NCRG will provide up to 30 individual sponsorships to attend the NCRG Conference. A portion of these scholarships may also include travel assistance up to $250. Scholarships are available to all interested attendees, especially those in the clinical and public health sectors.

Click here to download the application form.

To Apply:

Click hereto download the NCRG Need-based Scholarship Program form

– Provide answers to the application questions by number on the application, a separate document or in the body of your email

– Submissions can be made by email tocreilly@ncrg.orgor faxed to 978-552-8452 by Friday, July 20

– In return for their scholarship, recipients will be asked to submit a (minimum one-page) letter to the NCRG following the conference describing their experience at the event.

For more information, contact Christine Reilly, senior research director for the NCRG, atcreilly@ncrg.org, or 978-338-6610. Applicants will be notified of a scholarship no later than Wednesday, August 1. All of the materials are also available on theNCRG Conference scholarship webpage. You can find more information about the 13thAnnual NCRG Conference on Gambling and Addiction visitwww.ncrg.org/conference.

Make sure you apply today so that you can attend the 13th annual NCRG Confernece! Did you receive a scholarship last year? Let us know in the comments below!

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The NCRG on the Road blog series includes posts from NCRG staff members as they travel to continue the organization’s mission of funding the highest-quality research on gambling disorders and increasing public education opportunities. This post is from Nathan Smith, program officer for the NCRG, about his recent trip to Lynn, Mass.

On June 25, the entire NCRG staff was able to attend the fourth public educational forum on problem gambling hosted by theMassachusetts Gaming Commission (MGC). The MGC is in charge of regulating and licensing the new casinos in Massachusetts and convened several experts to speak about research on gambling disorders and provide recommendations on how to address this issue. I was pleased that the work of the NCRG was on display throughout the course of the meeting, including testimony from Christine Reilly, senior research director for the NCRG, and presentations from two NCRG board members and two NCRG-funded researchers.

Christine’s presentation to the MGC outlined the work of the NCRG and discussed some of the important lessons that our organization has learned from 16 years of funding high-quality research. Among these are the importance of having peer-review committees made up of quality independent scientists and creating a system through which the expertise of the scientists drives the research agenda and guides funding decisions. She also stated that the NCRG is willing to help the MGC in any way, from serving as a model in how to fund research to providing science-based resources for the community to use.

Other speakers added an important perspective to how they believe the MGC should approach pathological gambling in Massachusetts, including:

Marlene Warner, executive director of the Massachusetts Council on Compulsive Gambling (MCCG), explained the many resources that the organization has in place for problem and pathological gamblers in Massachusetts. The MCCG operates the state’s gambling hotline (1-800-426-1234) and educates the state’s 13 counseling centers with staff trained to treat gambling disorders. Warner also emphasized the devastating effects that a gambling disorder can have on the individual’s family and friends – a group that is sometimes not addressed.

Debi LaPlante,Ph.D.,director of research and academic affairs at the Division on Addiction, Cambridge Health Alliance, an affiliate of Harvard Medical School, gave a broad view of the state of the research on gambling disorders. She explained certain key facts that are very relevant to communities similar to Massachusetts, including the research showing that populations adapt to expanded gambling opportunities. That is, when a new community gains access to gambling, there is an increase in the number of gambling problems that community experiences, followed by a steady decline as the community adapts to having a gambling opportunity in its area. Dr. LaPlante illustrated this point with data from her own research on this topic.

Kevin Mullally, general counsel and director of government affairs of Gaming Laboratories International and former executive director of the Missouri Gaming Commission, presented during the afternoon session. Mr. Mullally, who also is an NCRG board member, discussed his time designing and implementing the first voluntary exclusion program in the United States and explained several of the best practices of voluntary exclusion programs that are currently in place. Mr. Mullally also gave more evidence for the adaptation of communities to gambling opportunities. Specifically after having over 14,000 people sign up for voluntary exclusion in the first few years of the program, only 3,000 more people have been added to the program since 2006.

Mark Vander Linden, the executive officer of the Office of Problem Gambling Treatment and Prevention at the Iowa Department of Public Health and new NCRG board member, focused his talk on the importance of peer-reviewed research on gambling disorders. He encouraged the commissioners to provide adequate funding for research and to continue the funding for research over the course of time (several presenters discussed the lack of long-term, repeated studies about how gambling effects populations).

Sarah Nelson, assistant director of research at the Division on Addiction and assistant professor of psychiatry, Harvard Medical School, used her presentation to discuss some of the general principles of taking a public health approach to gambling disorders. She also provided the MGC with specific examples of public health interventions that have found mixed results. For example, airbags in cars have been shown to save lives very effectively unless the passenger in the front seat is very small, in which case airbag deployment can be extremely dangerous. Dr. Nelson’s example shows the importance of studying the effects of an intervention before implementation for the general public.

Commissioners also heard testimony from Dr. Rachel Volberg, president of Gemini Research Ltd., and two individuals who are recovering from pathological gambling. There is information about the all of the speakers and topics discussed at this forum, including a complete video, available on theMGC’s website. You can also search the Twitter hashtag #MassForum for highlights from the NCRG’s live-tweeting session.

Stay tuned for the next NCRG on the Road blog series as Amy Martin travels to Milwaukee, Wisc., for the National Council on Compulsive Gambling annual conference today! If you’re attending, make sure to go to the “Resources at your Fingertips” session on July 14 from 11:30 a.m. – 12:30 p.m. in Executive Ballroom A/B.

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After the U.S. Supreme Court’s ruling on the Patient Protection and Affordable Care Act (ACA) last week, many experts have weighed in on the practical implications of this legislation regarding the prevention and treatment of addictive disorders. From federal entities such as the Substance Abuse and Mental Health Services Administration (SAMHSA) to national mental health organizations such as theAmerican Psychological Association, the statements issued clearly examine the overall impact of the ACA on mental health treatment. How does this historic ruling relate the field of addictions? The experts suggest the answer lies in three applications: integration of services, enhancing prevention initiatives and a new model of recovery services.

According to Dr. A. Thomas McLellan, pioneering addictions researcher, both health care reform and the Mental Health Parity and Addiction Equity Act (MHPAEA)[1]will foster the integration of addiction as a health problem into the larger health care system.’Until now, there has been no provision for benefits, training, teaching or development – or even recognition that care for substance use disorders is part of general health care,” said Dr. McLellan (Addiction Treatment Forum, 2010). Dr. McLellan, CEO of the Treatment Research Institute and former deputy director for the White House Office of National Drug Control Policy, will cover some of these implications during his keynote address at the 13thannualNCRG Conference on Gambling and Addiction.

Second, the ACA will increase support for prevention and early intervention initiatives, such as encouraging primary care providers to frequently administer screening and brief interventions for addictive disorders. This could ultimately result in more referrals for addiction treatment programs. Because of the ACA, an estimated 32 million Americans who are uninsured will now have access to such services. Various provisions of the law will require benefit packages to include treatment for mental health and substance use disorder services, prescription drugs, rehabilitative and prevention and wellness services (SAMHSA, 2010a).

A third result of the ACA will be the promotion of recovery-oriented systems of care (ROSC), a model that provides “a coordinated network of community-based services and supports that is person-centered and builds on the strengths and resiliencies of individuals, families, and communities to achieve abstinence and improved health, wellness and quality of life for those with or at risk” of developing a disorder (SAMHSA, 2010b). Through the legislation, Substance Abuse Prevention and Treatment block grants will be awarded by SAMHSA to fund implementation of ROSC throughout the U.S.

Currently, many public health officials are trying to understand where prevention and treatment of gambling problems fit inside the ROSC structure. The 13thannual NCRG Conference on Gambling and Addiction will address this issue with a session on how the Iowa Department of Public Health successfully integrated the treatment of gambling disorders as they implemented the ROSC model throughout the state. The NCRG Conference also will feature speakers such as Drs. Alexandre Laudet and H. Westley Clark who have been vital to the development and promotion of this new model of recovery. For more information and to download the NCRG Conference brochure, visit www.ncrg.org/conference.

Note: The NCRG is a nonpartisan organization and does not lobby for or against any types of legislation. The mission of the NCRG is to help individuals and families affected by gambling disorders by supporting the finest peer-reviewed research into pathological and youth gambling; encouraging the application of new research findings to improve prevention, diagnostic, intervention and treatment strategies; and advancing public education about gambling disorders and responsible gaming.

References

Addiction Treatment Forum. (2010).How Health Reform Will Affect OTPs — An Interview With A. Thomas McLellan.Retrieved fromhttp://www.atforum.com/newsletters/2010fall.php

SAMHSA. (2010a).HealthReform: Overview of the Affordable Care Act.Retrieved fromhttp://www.samhsa.gov/samhsanewsletter/Volume_18_Number_3/AffordableHealthCareAct.aspx

SAMHSA. (2010b).Recovery-Oriented Systems of Care (ROSC) Resource Guide. Washington, DC: Substance Abuse and Mental Health Services Administration.

[1]In 2008, the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 was signed into law. This legislation requires group health insurance plans (those with more than 50 insured employees) that offer coverage for mental illness and substance use disorders to provide those benefits in no more restrictive way than all other medical and surgical procedures covered by the plan.

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Registration is still open for the second session of the 2012 NCRG Webinar Series, taking place June 20, 2012, from 2 – 3 p.m. EST. The NCRG Webinar Series is a free, year-round educational program designed to help individuals better understand and address critical issues related to gambling disorders and responsible gaming – without having to leave their own home or office. Dr. Serena King, an assistant professor at Hamline University, will discuss her latest findings from an NCRG-funded study that examined the roles of genetics, environment and psychiatric disorders in the development of gambling disorders during the transition from youth to young adulthood.

To sign up for this free session, visit theNCRG’s upcoming webinar pageand click the registration link.

Participants can earn up to one hour of continuing education credit from ouraccrediting organizations: NAADAC, the National Board for Certified Counselors and the California Board for Behavioral Sciences. The NCRG is also approved by the American Psychological Association (APA) to sponsor continuing education for psychologists.

Register todayfor the free webinar, and pass along the registration information to interested counselors, social workers, marriage and family therapists and colleagues. Have a question for Dr. King regarding the genetic factors and environmental influences that relate to gambling disorders among youth? Leave your questions in the comment section below, and the NCRG blog team will report her answers! Also, keep watching for more information on upcoming sessions in the 2012 NCRG Webinar Series.

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The “NCRG on the Road” blog series includes posts from NCRG staff members as they travel to continue the organization’s mission of funding the highest-quality research on gambling disorders and increasing public education opportunities. This post is from Amy Martin, the NCRG’s communications and outreach manager, about her recent trip to the Midwest Conference on Problem Gambling and Substance Abuse in Kansas City, Mo.

The NCRG’s staff and representatives have been collecting frequent flyer miles as we’ve traveled across the country, presenting at conferences and meeting with public health officials, gaming industry representatives, clinicians and business leaders. In previous posts, I talked about ourtrip to Denver, Colo., to tape themulti-media news releasefor CollegeGambling.org, as well as our trip to Miami, Fla., for the sixthAnnual Education Summit. I packed my bags again for the opportunity to present at the Midwest Conference on Problem Gambling and Substance Abuse from June 6 – 8. Dr. Serena King, an associate professor at Hamline University, also joined me to present her latest research findings, thanks to an Early Stage Investigator Grant from the NCRG.

The ninth annual Midwest Conference brought together more than 200 clinicians, public health officials, regulators and addiction recovery professionals from Kansas, Missouri, Nebraska, Illinois and Iowa. This annual conference offers participants an opportunity to interact with a diverse community committed to making a difference and to learn from nationally recognized experts in the field. Additionally, it is an opportunity to network with national and international educators and researchers to discover resources that enhance quality services for individuals with problem gambling and substance abuse behaviors.

Themed “Utilizing Evidence-based Practices,” the event featured sessions on prevention efforts, assessments and treatment of gambling disorders and substance use disorders. The meeting also included special trainings on suicide prevention in conjunction with the Missouri Suicide Prevention Project.

I was delighted to learn that the conference’s kickoff keynote speaker was Rear Admiral Peter Delany, Ph.D., director of the Office of Applied Studies at the Substance Abuse and Mental Health Services Administration (SAMHSA) within the U.S. Department of Health and Human Services. Trained as a social worker, Rear Admiral Delany gave an overview of SAMHSA’s national initiatives toward recovery-oriented systems of care for addiction. Overall, he emphasized the need to have more peer-reviewed research on gambling disorders, especially prevention and treatment. He also encouraged attendees to be involved in SAMHSA’s Recovery Month this coming September, and we hope to integrate that program into the 13thannual NCRG Conference on Gambling and Addiction.

It was my pleasure to lead a breakout session on various free and low-cost resources that are available for mental health treatment providers to learn more about gambling disorders and lead public education efforts about this issue. We covered new avenues to obtain continuing education credits, such as theNCRG’s free webinaron June 20 and the scholarships that are available to attend the NCRG Conference. We also discussed various ways to learn more about upcoming trainings, including the Iowa Substance Abuse Information Center’s weekly email and other organizations’ event calendars, including the Massachusetts Council on Compulsive Gambling and the National Council on Problem Gambling. It was a great conversation about what resources are needed for clinicians to better educate their clients, and what ways that they can access existing tools.

On June 7, Dr. King led the keynote session about her NCRG-funded research that analyzed the genetic and environmental factors that impact gambling disorders among youth. Her study examined the Minnesota Twin Family Study, a survey of 1,320 sets of twins who were measured at ages 18 and 25. Dr. King explained that this particular twin study allowed her to estimate the difference in problematic gambling behavior by measuring two variables. First, she studied the differences between fraternal and identical twins to understand the genetic factors that played a role in behavior variances. Second, she examined the environments in which those sets of twins grew up and compared those sets that grew up in a “shared” environment (e.g. similar backgrounds) or a “non-shared” environment (e.g. the twins were raised in separate circumstances). “It is important to use twin studies when trying to understand the genetics versus environment question simply because it lets you have a clearer distinction of where to draw lines and measure variables,” Dr. King said.

The results from this study showed two clear trends. Primarily, there was an increase in the influence of genetics in excessive gambling behavior from ages 18 to 25. When researchers measured this factor at those separate time points, they found that the influence of the twins’ genes grew over time. When measuring the environmental influences, Dr. King found that the shared environment variable was only influential at age 18 and not age 25, but that non-shared environment factors were influential at both ages. These results indicate that both genes and the surrounding environment impact how gambling disorders develop among young adults. More research is needed to further examine these relationships.

To learn more about Dr. King’s work, you can register today for the next NCRG Webinar on June 20. Dr. King will expand on this topic, and participants can earn continuing education credits for their attendance. Visit the NCRG’s Public Education and Outreach section ofwww.ncrg.orgfor more information.

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How many people have a gambling problem? That is the simple question posed by prevalence studies on gambling disorders. However, media reports and scientific articles reveal that this is not a simple issue. This Gambling Disorders 360˚ post is the first in a series called “Gambling Disorders Explained.” We are including these types of posts to help simplify and increase understanding of the different types of studies that exist about gambling disorders, as well as explain contributing factors to various research outcomes about this disorder.

First, if you’re confused by the many terms used to describe gambling addiction, you’re not alone. These labels include “problem gambling,” “pathological gambling,” “compulsive gambling,” “gambling addiction,” “at-risk gambling,” “low risk gambling” and “probable pathological gambling.” One reason for the variety of terms is the multiplicity of screening instruments such as, to name just a few, the SOGS and the NODS (Lesieur & Blume, 1987; Gerstein, 1999). All use their own unique terms. Many of these screens utilize a category, often called “problem gambling,” to identify people who are having some problems as a result of their gambling but do not meet diagnostic criteria for pathological gambling, the most severe form of the disorder.

It is important to note that the diagnosis for pathological gambling in the American Psychiatric Association’sDiagnostic and Statistical Manual of Mental Health Disorders(DSM) does not provide a subclinical or problem gambling category (American Psychiatric Association, 1994). In other words, the person either meets five or more of the 10 criteria for a diagnosis of pathological gambling or does not. Consequently, neither the current DSM-IV diagnosis nor the proposed DSM-5’s designation for the new term “gambling disorder,” provide any guidance for the threshold for subclinical gambling. The proposed shift from “pathological gambling” to “gambling disorder” addresses the frequent complaint that “pathological gambling” is a pejorative term that only serves to reinforce a highly stigmatized disorder (American Psychiatric Association, 2011).

Another source of confusion when it comes to determining how many people have a gambling problem is the fact that scientists and the media often lump together the prevalence rate for subclinical or problem gambling and pathological gambling when talking about the issue. This can be confusing because research has shown that these two numbers are distinct, and if they are combined, it misrepresents the facts. In fact, approximately less than one percent of the adult population is diagnosed with pathological gambling and 2.3 percent is shown to have a subclinical or problem gambling diagnosis (Kessler et al., 2008).

Combining the problem gambling and pathological gambling prevalence rates can also be misleading because there is a lack of consensus in the field about the meaning of “subclinical.” Many maintain that this group is at risk and that since pathological gambling is a “progressive” disorder as defined by the DSM, subclinical gambling problems will likely develop a full blown disorder. However, other investigators have observed a more dynamic phenomenon and concluded that many people move back to a healthy state from a subclinical status (Slutske at al., 2003; Shaffer et al. 2002).

It also is often unclear whether the media is reporting past-year or lifetime prevalence rates in its stories. Lifetime rates of prevalence are always higher because they include cases of gambling disorders that have since resolved. Studying lifetime rates is important if investigators are analyzing issues such as age of onset (e.g., Kessler et al., 2008). On the other hand, past-year rates are vital for answering the question, how many people have the disorder now? Past-year rates are vital for public health planners who need to deal with the here and now in their work.

Ultimately, it is important for researchers, media and those who are keenly interested in this topic to be precise in how they define and talk about gambling disorders and the rates of those who are affected with the psychological problem. That is why it’s important to examine the most recent peer reviewed studies. Resources such asTHE WAGERand Gambling Disorders 360 ° are a quick and easy way to stay informed.

Another source of confusion is the difference between prevalence and incidence studies. This topic will be covered in an upcoming blog post for this series.

Do you have questions or comments about the concepts discussed in this blog? Is there another aspect of research on gambling disorders that you would like to have explained in a Gambling Disorders 360˚ post? Please submit your suggestions in the comments section below.

References

American Psychiatric Association. (1994).DSM-IV: Diagnostic and Statistical Manual of Mental Disorders(Fourth ed.). Washington, DC: American Psychiatric Association.

American Psychiatric Association. (2011). DSM-V: The Future of Psychiatric Diagnosis. Retrieved August 23, 2011, from www.dsm5.org

Gerstein, D., Murphy, S., Toce, M., Hoffmann, J., Palmer, A., Johnson, R., et al. (1999).Gambling Impact and Behavior Study: Report to the National Gambling Impact Study Commission. Chicago: National Opinion Research Center.

Kessler, R. C., Hwang, I., LaBrie, R., Petukhova, M., Sampson, N. A., Winters, K. C., et al. (2008). DSM-IV pathological gambling in the National Comorbidity Survey Replication.Psychological Medicine, 38(9), 1351-1360.

Lesieur, H. R., & Blume, S. B. (1987). The South Oaks Gambling Screen (SOGS): A new instrument for the identification of pathological gamblers.American Journal of Psychiatry, 144(9), 1184-1188.

Shaffer, H. J., & Hall, M. N. (2002). The natural history of gambling and drinking problems among casino employees.Journal of Social Psychology, 142(4), 405-424.

Slutske, W. S., Jackson, K. M., & Sher, K. J. (2003). The natural history of problem gambling from age 18 to 29.Journal of Abnormal Psychology, 112(2), 263-274.

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