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2011 was a year of growth for the NCRG. We have many accomplishments to celebrate, from the launch of afirst-of-its-kind online resourcefor college students and administrators to aredesigned websiteandnew social media channels. Taking a cue fromDr. Thomas Insel, director of the National Institutes of Mental Health, we decided to make a list of the NCRG’s top 11 accomplishments in 2011.

1. A Successful Road Tour: In July, the NCRG went to Boston, Mass., to hold key stakeholder events to increase awareness of gambling disorders and responsible gaming, including a treatment provider workshop on the connection between post-traumatic stress disorder and problem gambling and meetings to discussCollegeGambling.org. We also formed a strong partnership with the Massachusetts Council on Compulsive Gambling as a result of this trip. The meetings spurred many great ideas for future projects, and we were able to give additional resources to help promote responsible gaming in the state.
2. The NCRG became more involved in socialmedia:The NCRG launched a Twitter account,@theNCRG, which now has more than 300 followers. It is our hope to use this platform to give the real-time information and latest research on gambling disorders and addictions. We can’t wait to interact more with our Twitter followers, and it’s our goal to live-tweet more events this year.
3. A Redesigned Website:NCRG.orgreceived some enhancements in November, making it easier to find information about the NCRG Conference on Gambling and Addiction, NCRG-funded research studies and more. Keep checking back to the NCRG’s website as we add new content in the coming year.
4. The Creation and Launch of CollegeGambling.org: After the Task Force on College Gambling Policies published their science-based recommendations in 2009 about how to address gambling and gambling-related harm on college campuses, the NCRG began to develop an online resource to help in that effort. In March 2011, the NCRG launchedCollegeGambling.orgas a free, easy-to-use online resource for students, university administrators, college mental health professionals and parents. We are very excited to grow this resource as new research and tools become available.
5. New Resources and Continuing Education for Clinicians – All Available Without Having to Leave the Office: The2011 NCRG Webinar Serieswas popular last year, and sessions covered subjects including discussions about gambling disorders among youth and college students. Dr. Ken Winters from the University of Minnesota simplified the neurobiology behind adolescent brain development in the August 24 session, and the NCRG released the sixth edition ofIncreasing the Odds: A Series Dedicated to Understanding Gambling Disordersin conjunction with this training. We also became an approved continuing education sponsors for the American Psychological Association (APA) and NAADAC, the Association for Addiction Professionals.
6. Partnership with NAADAC, the Association for Addiction Professionals: The NCRG was fortunate to partner with NAADAC on a few additional projects this year. NAADAC co-sponsored the March 23 webinar session titled “Gambling Disorders: What Addiction Professionals Need to Know,” which was the most popular webinar in 2011. Christine Reilly, senior research director for the NCRG, and Dr. Randy Stinchfield, professor of psychiatry at the University of Minnesota, also led a session at NAADAC’s annual conference in September. There is more to come with this partnership in 2012, so stay tuned.
7. 2011 NCRG Conference on Gambling and Addiction: Last year, theNCRG Conferencebrought the best conversations and research in the field of gambling disorders and addiction to one event. From Dr. Gary Small, UCLA, to Dr. Scott Teitelbaum, University of Florida College of Medicine, keynote speakers at the NCRG Conference covered the impact of technology on treatment, research and responsible gaming. Dr. Jon Grant, University of Minnesota, and Dr. Marc Potenza, Yale, represented theNCRG Centers of Excellence in Gambling Researchby presenting their latest work in both pre-conference sessions and keynote addresses. For additional conference session summaries, visit the NCRG Conference blog posts onGambling Disorders 360˚.
8. The NCRG’s First Treatment Provider Workshop Series: To help clinicians better understand the most up-to-date research on gambling disorders and apply those findings to their clinical practice, the NCRG created theTreatment Provider Workshop Series. We held five free workshops this year for more than 225 clinicians across the nation, and we are planning to expand the workshop series to include more cities in 2012.
9. Increased Funding for Research: In 2011, the NCRG awarded more than $545,000 to support research that will help improve methods of diagnosis, intervention, treatment and prevention of gambling disorders. We look forward to learning about these researchers’ findings, and we will be announcing the 2012 call for applications soon. Please visit theNCRG Research Centeron our website for more information.
10. Helped Students “Know the Odds”:The NCRG was able to partner with Young Minds Inspired to create and distribute our “Know the Odds” curriculum to middle and high school students in more than 400 schools, reaching more than 94,000 students, faculty and parents. This curriculum also included copies of“Talking with Children about Gambling”for students to take home and share with their parents.
11. Milestones in Research Publications:We are pleased to announce that NCRG-funded research has resulted in more than 200 peer-reviewed articles published in top-tier academic journals! This is quite an accomplishment, and we are grateful to the researchers, peer-review panels, Scientific Advisory Board and donors for making this possible.

These are only a few of the highlights from 2011, and we are looking ahead at what is to come in 2012. What are some of your top NCRG highlights from last year? Let us know in the comments below

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The National Center for Responsible Gaming (NCRG) today announced Alan M. Feldman, senior vice president of public affairs for MGM Resorts International, has been named the new chairman of the organization’s board of directors. Feldman replaces Glenn C. Christenson. Christenson, managing director of the investment firm Velstand Investments, LLC, who has served as chairman of the board of directors for three years and will remain on the board. The NCRG board also elected Mark Vander Linden, executive officer of the Office of Gambling Treatment and Prevention at the Iowa Department of Health, to join as a board member.

In an interview with the NCRG blog team, Christenson gave high praise for Feldman. “Alan has long been a strong voice in the gaming industry on issues of responsible gaming and finding effective methods for addressing gambling disorders. He has an unwavering commitment to the NCRG,” Christenson said. “I am delighted to remain on the NCRG board to support Alan’s leadership as the NCRG continues to address these issues through peer-reviewed research and public education.”

Feldman has served on the NCRG board since 2000. Throughout his career, he has taken a leadership role on a wide array of industry issues, with a particular focus in areas concerning responsible gaming. In addition to serving on the NCRG board, he is a board member for the Nevada Council on Problem Gambling and has previously served as a member of the Athletes and Addictions Task Force at Harvard University Medical School, Division on Addictions.

When asked about his new role, Feldman was honored to follow Glenn Christenson in this capacity. “Glenn has done an incredible job of leading the NCRG in creating new initiatives that help to translate the NCRG-funded research findings into practical, real-world applications,” Feldman said. ‘Under his astute leadership, the NCRG has created the NCRG Centers of Excellence in Gambling Research and extraordinary resources such as CollegeGambling.org. I hope to build on this success by expanding our efforts to raise awareness of problem gambling and responsible gaming through the top-notch, peer-reviewed research and public education initiatives that makes the NCRG a leading organization in this field.”

Another new face to the NCRG board is Mark Vander Linden, executive officer of the Office of Gambling Treatment and Prevention at the Iowa Department of Public Health. In this role, he oversees all problem gambling services for the state including treatment, prevention, workforce development, social marketing and evaluation. Vander Linden is also the board president of the Association of Problem Gambling Service Administrators and holds advisory roles with the Midwest Consortium on Problem Gambling and Substance Abuse and the Prairielands Addiction Transfer Technology Center.

“We are excited to have Mark on the NCRG board, as his experience will lend great insight on the public health perspective of problem gambling,” Feldman said. “He has already been a champion for the NCRG in helping us organize treatment provider workshops and speaking at the NCRG Conference of Gambling and Addiction, and we look forward to working with him more in the coming years.”

The NCRG board of directors includes representatives from the gaming industry and the treatment and regulatory communities. In addition to Feldman, Christenson and Vander Linden, the board includes NCRG President William S. Boyd, executive chairman of Boyd Gaming Corporation; NCRG Treasurer and Secretary Judy L. Patterson, senior vice president and executive director of the American Gaming Association; Sue Cox, founding executive director of the Texas Council on Problem and Compulsive Gambling; Kevin Mullally, general counsel and director of government affairs for Gaming Laboratories International; Phil Satre, chairman of International Game Technology; Jennifer Shatley, vice president of responsible gaming policies and compliance for Caesars Entertainment Corporation; and Bruce Shear, president and CEO of Pioneer Behavioral Health. To learn more about the NCRG board of directors, please visit ourwebsite.

Have a question or comment for a member of the NCRG board of directors? Leave it in the comments below!

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During the 12^thannual NCRG Conference on Gambling and Addiction, researchers presented more than 37 posters that showcased the latest studies on gambling disorders and responsible gaming. The posters included research such as a study of young adults that explored the connection between measures of problematic gambling behavior and impulsivity, and research that looked for associations of computer game involvement and problem gambling behavior among online players.

The lead author from the 2011 NCRG Conference Outstanding Poster award-winning research team is Dr. Iman Parhami, a postdoctoral research fellow in the department of psychiatry at the University of California, Los Angeles (UCLA) and a member of the UCLA Gambling Studies program. Click below for the NCRG blog team’s interview with Dr. Parhami to learn more about his winning research project and his experience at the NCRG Conference. For more information on the UCLA Gambling Studies program you canvisit their website.

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In October the Iowa Department of Public Health released a statewide report on gambling behavior and gambling disorders (Gonnerman & Lutz, 2011). Using the NODS instrument^[1]the study found the rate of pathological gambling (PG), the most severe form of the disorder, in the past 12 months to be 0.3 percent. Using the PGSI instrument, researchers found that past-year rates of PG to be 0.6 percent. These rates are similar to the prevalence rate found in large-scale national surveys, such as the National Comorbidity Survey Replication (NCS-R) that reported a past-year rate for pathological gambling of 0.3 percent (Kessler et al., 2008). The Iowa report used two screening measures to collect data: the National Opinion Research Center’s DSM Screen (NODS) (Gerstein et al., 1999) and the Problem Gambling Severity Index (PGSI), a validated brief measure based on the Canadian Problem Gambling Severity Index (CPGI) (Ferris & Wynne, 2001).

In the Iowa report, the researchers presented rates of problem gambling, which is a less severe form of the disorder that includes people who experience some gambling-related problems but not enough to be considered pathological gamblers (the PGSI refers to this group as “Moderate Risk”). The researchers found that 0.2 percent (NODS) and 2.6 percent (PGSI) of adult Iowans can be categorized as problem gamblers.

The difference between the NODS and PGSI rates may be due to the differing emphasis of the measures. The NODS was modeled on the American Psychiatric Association’s (APA) criteria for PG while the PGSI was designed to take more social and environmental factors into consideration. The PGSI’s authors have previously hypothesized that this emphasis has probably caused the PGSI to report higher rates of moderate and low risk gambling than other measures (Ferris & Wynne, 2001). However, both of the rates reported in the Iowa study are similar to rates found in other national studies (e.g., Kessler et al., 2008). It is also important to remember that people in both the subclinical group (those who experience some problematic symptoms but not enough for a problem or pathological classification) and problem gambling group often move to groups with both more and fewer symptoms (Shaffer & Hall, 2002). That is, today’s subclinical gambler could be tomorrow’s non-gambler.

The Iowa study also presented a variable that these researchers called “Any Problem Gambling Symptom.” This variable included everyone in the sample who had experienced any symptom on the NODS or the PGSI screens during the past year, as well as those who answered affirmatively to an additional question that the researchers added for people to self-identify as having gambling problems. The study found that 13.1 percent of the sample fit into this “Any Problem Gambling Symptom” group, though it was not clear from the study why the researchers combined these three separate measures in this way and reported it as one all-inclusive percentage.

The Iowa report represents the first time that the NODS, the PGSI and the additional question have been combined in this way. For this reason there are no other studies to compare this rate to, nor is there any data on the characteristics of this participant group or information on what this group is likely to do (or not do) in the future. This is atypical in research studies because new variables are typically released with substantial theoretical and psychometric data to explain precisely what it is measuring and how it could be useful to the field.

There are other potential problems with combining these measurements in this way. First, there has been very limited research on people with subclinical gambling problems and it is not clear that having one symptom is meaningful in population studies. This is particularly true for lifetime measures, but past-year measures can also be problematic. For example, if a person reports that they once drank a lot of alcohol and it took them a few days to fully recover, then they have met one criterion for alcohol dependence, according to the APA’sDiagnostic and Statistical Manual of Mental Disorders(American Psychiatric Association, 1994). However, this doesn’t mean that they should be considered “at-risk” for alcohol dependence or that they will develop alcohol dependence in the future (most people respond to negative consequences by changing their behavior). One place where it is important to know if a person has had even one symptom of a gambling (or alcohol) disorder is in a clinical setting. This information may be beneficial to a treatment provider as they try to understand the individual and conduct further assessment. However, the usefulness of this data in a population study is not well understood and needs to be the focus of significant research before it is used as a valid and useful variable.

Another concern is the tendency of the public, and sometimes the media, to misunderstand the implications of such a finding by believing that a larger percentage of people are “at-risk” for developing a gambling disorder. Media reports that are not clear about subclinical gambling problems may add to this confusion. Is this report suggesting that 13.1 percent of Iowans will become pathological gamblers? The researchers did not draw this conclusion, and new research, referenced above, shows that individuals with some gambling problems, but not PG, are as likely to move back to health as they are to more problems. In other words, being “at-risk” is not necessarily a slippery slope to PG. While this study found rates of PG and problem gambling similar to the rest of the U.S., more research is needed on people that display at least one symptom of gambling disorders but do not meet diagnostic criteria for problem or pathological gambling.

References

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

Ferris, J., & Wynne, H. (2001). The canadian problem gambling index: user’s manual.Toronto (ON): Canadian Centre on Substance Abuse.

Gerstein, D., Murphy, S., Toce, M., Volberg, R. A., Harwood, H., & Tucker, A. (1999).Gambling Impact and Behavior Study. Report to the National Gambling Impact Study Commission, April 1, 1999.(p. 104). Chicago, IL: National Opinion Research Center. Retrieved from http://ezp-prod1.hul.harvard.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=nts&AN=PB2002-104073%2fXAB&site=ehost-live&scope=site

Gonnerman, M. E., & Lutz, G. M. (2011).Gambling Attitudes and Behaviors: A 2011 Survey of Adult Iowans(p. 125). Cedar Falls. IA: Center for Social and Behavioral Research, University of Northern Iowa.

Kessler, R. C., Hwang, I., LaBrie, R., Petukhova, M., Sampson, N. A., Winters, K. C., & Shaffer, H. J. (2008). DSM-IV pathological gambling in the National Comorbidity Survey Replication.Psychol Med,38(9), 1351-60. doi:S0033291708002900 [pii] 10.1017/S0033291708002900

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

[1]Discussed with other measures, below.

NCRG staffResearch UpdateIowaprevalence rates

In 2009, the NCRG’s Task Force on College Gambling Policies recommended that colleges and universities promote understanding of gambling disorders as a mental health issue and provide assessment and intervention resources to address gambling disorders among college students. To assist schools with this recommendation and provide science-based tools to address gambling and gambling-related harms on college campuses, the NCRG launchedwww.CollegeGambling.org, a comprehensive online resource, in March 2011.

Research shows that approximately 75 percent of college students gambled during the past year, whether legally or illegally. Researchers from Montclair State University recently published a study about problem gambling awareness messages on college counseling center websites (CCW) to determine what types of information students received about gambling disorders and treatment (McKinley & Wright, 2011). This study further highlights the need for resources like CollegeGambling.org.

The authors argue that CCWs are a critical resource because college students, typically habitual Internet users, are likely to value problem gambling messages found online. Furthermore, research suggests that students perceive information on CCWs to be trustworthy and useful (Van Brunt, 2008). Online health information gathered anonymously is also likely to be appreciated by individuals struggling with a behavior that potentially carries a stigma, such as pathological gambling (Napoli, 2001).

The authors evaluated the content of 203 CCWs based at 4-year, largely residential colleges and universities. They studied whether the institutions’ CCWs offered the same level of information and services for problem gambling as they do for depression, stress/anxiety, pathological eating and alcohol and substance use. Their analysis showed that only 15 percent of the CCWs mentioned problem gambling. More specifically,

• Less than 1 percent mentioned problem gambling on the home page
• Almost 5 percent mentioned individual counseling for gambling problems
• Less than 1 percent mentioned group counseling for problem gambling
• Less than 5 percent provided a pamphlet on gambling problems
• Less than 3 percent provided a link to a pamphlet
• Less than 2 percent mentioned a self-help group for gambling
• Less than 3 percent provided a link to a self-help group
• Less than 5 percent provided a link to an issue-specific website devoted to gambling disorders
• Less than 3 percent offered a self-assessment
• Less than 1 percent mentioned educational outreach for problem gambling

The authors concluded that compared with the other health topics cited above, viewing gambling as a public health issue is a relatively new phenomenon (Korn & Shaffer, 1999), accounting for the low level of awareness of problem gambling among CCWs.

Want to learn more about gambling and gambling-related harms on college campuses? Make sure you visit CollegeGambling.org for the latest information and check back for additional information and resources.

References

Korn, D.A., & Shaffer, H.J. (1999). Gambling and the health of the public: Adopting a public health perspective.Journal of Gambling Studies, 15, 289-365.

McKinley, C.J., & Wright, P.J. (2011). Examining the presence of problem gambling awareness messages on college counseling center websites.Health Communication. doi: 10.1080/10410236.2011.571756.

Napoli, P.M. (2001). Consumer use of medical information from electronic and paper media. In R.E. Rice & J.E. Katz (Eds.)The Internet and Health Communication(pp. 79-98). Thousand Oaks, CA: Sage.

Van Brunt, B.J. (2008).Practical suggestions for improving your counseling websitePaper presented at Magna Publications, Madison, WI.

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