New Research On Minorities And Gambling

Gambling and gambling related problems are common among all racial and ethnic groups in the United States, but there is new evidence that African Americans are more likely to experience gambling-related problems than white Americans. Differences in problem and pathological Gambling (PPG) among people of different races are not well understood. A better understanding of gambling behaviors, gambling problem severity and other psychiatric disorders associated with PPG in minority populations could benefit gambling prevention and treatment programs. For this reason we have devoted the February edition ofIssues & Insightsto new research on the differences in gambling behavior and PPG between black and white Americans.

A recently published study by Dr. Declan Barry and colleagues(Barry, Stefanovics, Desai, & Potenza, 2011)analyzed data from The National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), the largest prevalence study of psychiatric disorders in the United States(Petry, Stinson, & Grant, 2005). Dr. Barry and co-authors compared black and white respondents on measures of gambling behavior, PPG, mental health, and the co-occurrence of mental disorders and gambling. In the following interview, Dr. Barry clarifies and expands on the findings in his recent paper.

I & I: What are the major findings of this study?

Dr. Barry: Among a nationally representative sample of 32,316 black and white adults in the United States, black respondents (.96 percent) were more likely than white respondents (45 percent) to exhibit past-year PPG. Higher proportions of black problem or pathological gamblers, as compared with white ones, were women (49 percent vs. 32 percent). Elevated rates of anxiety, mood, and substance use disorders, as well as personality disorders, were found among black and white problem or pathological gamblers. Black respondents were more likely than white ones to exhibit a stronger relationship between subsyndromal[i]gambling and any mood disorder, hypomania, and any substance-related disorder.

I & I: Are these findings consistent with past research on this subject?

Dr. Barry: Consistent with previous research, we found that black respondents exhibited higher rates of PPG than white respondents. Our finding that higher proportions of black problem or pathological gamblers were women, as compared to the white population, is consistent with prior findings that racial minority women may be at particularly high risk of PPG. Similar to previous studies, we found that PPG was associated with elevated rates of Axis I and Axis II[ii]psychopathology for black and white respondents. However, we also found that, in comparison to white respondents, black respondents were more likely to exhibit a stronger relationship between subsyndromal gambling and any mood disorder, hypomania, and any substance-related disorder.

I & I: How do these findings compare to research about minorities and other addictive disorders such as substance use disorders?

Dr. Barry: Studies have found that community-dwelling (that is, non-institutionalized) blacks and whites generally have similar prevalence rates of psychiatric disorders; however, more African Americans belong to at-risk groups (e.g., homeless) that typically exhibit higher rates of psychopathology. Prior research using NESARC data has found that blacks and whites exhibit comparable rates of past-year drug use disorders.

I & I: Why is it important to study the effects of race or gender on gambling disorders?

Dr. Barry: In the long term, an increased understanding of the effects of race or gender may provide important information about the development and maintenance of PPG and may suggest targeted treatment for PPG. For example, possible differences in motivation among men and women or among individuals from different racial backgrounds may suggest optimal intervention strategies. Thus, if differences emerge on proclivity to engage in gambling to escape distress, these differences might be specifically targeted by clinicians.

I & I: How can findings like these help clinicians working with people with gambling problems, or public health policy makers?

Dr. Barry: The robust associations between PPG and Axis I and II disorders offer support for the routine assessment of psychiatric disorders among patients seeking gambling treatment. Our findings suggest that public health policy makers might benefit from attending to subsyndromal levels of gambling (and not solely PPG) since race-related differences in the association between subsyndromal levels of gambling and mood as well as substance-use disorders were found in the present study.

Declan Barry, Ph.D., is a clinical psychologist, an assistant professor in the department of psychiatry at Yale University School of Medicine, and director of the APT Foundation Inc, Pain Treatment Services. Dr. Barry’s research is aimed at: (1) developing and evaluating treatments for patients with co-occurring opioid addiction (e.g., prescription opiates, heroin) and chronic pain (i.e., physical pain lasting at least 3 months); and (2) examining the role of sociocultural factors in the occurrence and treatment of addictions (e.g., gambling, eating disorders, substance-related disorders).

References

Barry, D. T., Stefanovics, E. A., Desai, R. A., & Potenza, M. N. (2011). Differences in the Associations between Gambling Problem Severity and Psychiatric Disorders among Black and White Adults: Findings from the National Epidemiologic Survey on Alcohol and Related Conditions.The American Journal on Addictions,20(1), 69-77. doi:10.1111/j.1521-0391.2010.00098.x

Petry, N. M., Stinson, F. S., & Grant, B. F. (2005). Comorbidity of DSM-IV pathological gambling and other psychiatric disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions.The Journal of Clinical Psychiatry,66(5), 564-574.

[i]A person with subsyndromal gambling exhibits gambling-related behaviors and problems that do not meet the threshold for pathological gambling.

[ii]Axis I refers to psychiatric disorders such as depression or bipolar disorder, while Axis II refers to personality disorders such as borderline personality disorder or antisocial personality disorder.

Declan T. Barry, Ph.D. Assistant Professor of Psychiatry Department of Psychiatry, Yale University School of MedicineIssues & Insights

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NCRG Announces 2011 Funding Opportunities

The National Center for Responsible Gaming is pleased to announce it has allocated more than $700,000 for grants in support of research on prevention and treatment of gambling disorders in 2011. The grants, ranging from $10,000 to $100,000 per year, will be awarded on a competitive basis. Applicants may seek one-year Exploration and Seed Grants to fund pilot data, a new direction on an existing project, secondary analysis of existing data, or small, self-contained research projects. Large Grants of up to $75,000 per year for two years are available for more extensive research projects.

The NCRG is dedicated to fostering the next generation of gambling researchers and, therefore, has added two career development awards for 2011. The Early Stage Investigator Grant and the Postdoctoral Fellowship are intended for researchers within 10 years and five years of their terminal degrees.

The NCRG also announced a request for applications for the development and testing of an online screening and brief intervention for college students. The resulting program will be located on the NCRG’s website, collegegambling.org, which is scheduled to launch in 2011.

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New Study Examines Potential Of Alzheimer’s Drug For Treating Pathological Gambling

Although pathological gambling (PG) has been recognized as a psychological disorder since 1980, there are still no FDA-approved medications to treat the disorder. Until now, most pharmacological treatments for PG have been adapted from treatments from other addictive disorders such as alcohol dependence. A recently published article in the journalPsychopharmacologyreports on the use of a drug from an unexpected source: a treatment for Alzheimer’s disease (Grant, Chamberlain, Odlaug, Potenza, & Kim, 2010).

Previous pharmacological research has suggested that people with PG experience imbalances in the part of the brain that mediates urges and the part that mediates cognitive control. Pharmacological treatments for PG, such as naltrexone, which is also used for reducing cravings for alcohol, have generally focused solely on reducing the urge to gamble. However, the authors of this study conjecture that memantine, a drug used to treat people with Alzheimer’s disease, has the potential to improve cognitive control in addition to reducing urges to gamble. The researchers hypothesized that the same chemical properties that improve brain function in people with Alzheimer’s disease may improve the brain function that mediates cognitive control.

To test this concept, the researchers conducted a pilot study that followed 29 subjects who took the drug for 10 weeks. The researchers found that, after 10 weeks, the participants significantly decreased the amount of time and money they spent gambling, and reported significantly lower desire to gamble. More promising than this, the participants were no longer significantly worse than the control group at tasks that test impulsivity and, most importantly, cognitive flexibility[i]. These improvements in brain function suggest that memantine should be further explored as a novel pharmacological treatment for PG.

More information on the article inPsychopharmacologyis available onthe journal’s website. What are your thoughts about drug treatments for gambling disorders? Tell us in the Comments section below.

References

Grant, J. E., Chamberlain, S. R., Odlaug, B. L., Potenza, M. N., & Kim, S. W. (2010). Memantine shows promise in reducing gambling severity and cognitive inflexibility in pathological gambling: a pilot study.Psychopharmacology,212(4), 603-612. doi:10.1007/s00213-010-1994-5

[i]Cognitive flexibility is the ability to switch behavioral responses according to the context of a situation. At the beginning of the trial,participants with PG had significantly worse cognitive flexibility scores when compared to controls.

NCRG staffResearch Updategambling addictionJon E. Grantnew researchtreatment for pathological gamblingUniversity of Minnesota

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New Research On Youth Video Game Playing

With publication of theDSM-5likely to move Pathological Gambling from its current clinical classification as an Impulse Control Disorder to a new category called “Addiction and Related Disorders,” there is growing interest in other potential “behavioral addictions.” One such behavior, video game playing, is the subject of a new study conducted by researchers at Yale University School of Medicine and published in the journalPediatrics(Desai, Krishnan-Sarin, Cavallo, & Potenza, 2010).

The researchers surveyed 4,028 representative adolescents about their video game playing, substance use, physical and mental health, high risk behaviors, and demographics. The results showed that moderate video game playing was not associated with any negative health outcomes in boys, but girls who played video games were more likely to have gotten into a serious fight or carried a weapon to school. One reason for this gender difference may be that playing video games is normative for boys (over 75 percent of boys surveyed played video games) but not for girls. The researchers cautioned against blaming video games for making girls more aggressive as it is equally possible that more aggressive girls are drawn to video game playing.

About 5 percent of the adolescents surveyed met the researchers’ criteria for problematic gaming (defined as trying to cut back, experiencing an irresistible urge to play, and experiencing a growing tension that can only be relieved by playing video games), with boys meeting the criteria about twice as often as girls. Adolescents meeting the criteria for problematic gaming were also more likely to regularly smoke cigarettes, use drugs, be depressed, and have been in serious fights.

More information on the article inPediatricsis available onthe journal’s website. What are your thoughts on this or other possible behavioral addictions? Tell us in the Comments section below.

References

Desai, R. A., Krishnan-Sarin, S., Cavallo, D., & Potenza, M. N. (2010). Video-gaming among high school students: health correlates, gender differences, and problematic gaming.Pediatrics,126(6), e1414-1424. doi:10.1542/peds.2009-2706

NCRG staffResearch Updatebehavioral addictionsvideo games

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Balancing Research And Respect: Researching Indigenous Populations

Gambling among ethnic and racial minorities, especially indigenous groups, is an important and largely untapped area for research, which has historically fallen short of its potential because of tensions between researchers and aboriginal peoples. For example, in the U.S., many Native Americans believe that research conducted on their tribes, especially projects on addictive behaviors, has been characterized by unethical practices (as discussed in ourJan. 2010Issues & Insights). Reminding us that these issues have worldwide import, a recent study published in theAustralian and New Zealand Journal of Public Healthexplores the relationships between researchers and Indigenous Australians, and proposes several practical solutions to these problems in the context of a community survey of gambling behaviors of aboriginal Australians (Hing, Breen, & Gordon, 2010).

The authors describe their preparation to conduct a survey on what they perceived to be “a highly sensitive issue – gambling and gambling problems” (Hing, Breen, & Gordon, 2010, p. 547). Using the 2006 report by Australia’s National Health and Medical Research Council (National Health and Medical Research Council, 2006), they discuss the ethical values that guided their study as well as the steps they took to complete their research project with the full support of the community. The researchers emphasized respect and reciprocity in their research design and included several benefits for the community being surveyed directly in their grant proposal (such as jobs for 26 research assistants, an art contest in the local schools, a formal presentation of results to the elders of the community, and a $10,000 community donation).

The researchers also discuss the tension between culturally respectful research and ideal research methods. For example, the research assistants hired from the community surveyed their friends and family to build confidence before going out into the community. Surveying friends and family has the potential to introduce bias into the study but was a necessary step for the inexperienced research assistants. This bias would not have been introduced had the researchers brought in professional research assistants from outside community, but the researchers decided that the small amount of bias introduced was far outweighed by winning the trust of the community.

More information on the article in theAustralian and New Zealand Journal of Public Healthis available on the journal’swebsite. What are your thoughts about culturally respectful research practices? Tell us in the Comments section below.

References

Hing, N., Breen, H., & Gordon, A. (2010). Respecting cultural values: conducting a gambling survey in an Australian Indigenous community.Australian and New Zealand Journal of Public Health,34(6), 547-553. doi:10.1111/j.1753-6405.2010.00624.x

National Health and Medical Research Council. (2006).Keeping research on track: a guide for Aboriginal and Torres Strait Islander peoples about health research ethics. Canberra. Retrieved fromhttp://www.nhmrc.gov.au/publications/synopses/e65syn.htm

NCRG staffResearch Updategambling among minoritiesgambling in Australiaindigenous Australians

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NCRG Awarded $380,466 In Research Grants In 2010

The National Center for Responsible Gaming (NCRG) recently announced it awarded $380,466 in project grants in 2010 for five new research projects on topics ranging from a laboratory simulation of Internet gambling to an intervention for college students at risk for developing gambling problems. The recipients of these grants are investigators based at the University of Florida, Duke University, Southern Illinois University, the University of Missouri and the University of Minnesota.

The NCRG grants were selected by independent peer review panels and the Scientific Advisory Board, which guides the NCRG’s grant making. The awards were made in three new categories adopted in 2010: Exploration Grants, Seed Grants and Large Grants.

The following summaries describe the 2010 grant awards:

Exploration Grant

  • Many believe that online wagering is riskier than other forms of gambling; however, there are few studies evaluating problematic gambling on the Internet. Yijun Liu, Ph.D., River Branch Professor and chief of the Division on Global Health at the University of Florida, seeks to fill this void with a project funded by a $5,400 Exploration Grant. The project will develop a virtual Internet gambling website to be used as a simulation in a laboratory experiment involving 12 subjects who meet the criteria for pathological gambling and 12 control group members. Using an fMRI brain scanner, Dr. Liu will seek to understand the neural pathways involved in excessive gambling and discern what is unique about the online gambling experience for people with gambling-related problems.

Seed Grant

  • Gambling is all about making choices, and gambling disorders are characterized by poor judgment and risky decision-making. Scott Huettel, Ph.D., associate professor of psychology and neuroscience at Duke University, was awarded $34,500 to test the hypothesis that whether someone makes a risky or safe choice depends not simply on preferences, but on the strategies they use to acquire and integrate new information. The research team will investigate the information-acquisition process in real time using high-speed, high-resolution tracking of eye movements and tasks that involve incentive-compatible decisions between economic gambles. They will evaluate how factors that contribute to risk-seeking choices alter how people process new information about risks and rewards. Dr. Huettel explained, “By tracking how people move their eyes when they make risky decisions, we will gain a better understanding of how they acquire and integrate information about risks and rewards. In turn, this understanding will provide insight into why environmental cues lead some people to make unwanted risky decisions, while others are unaffected.”
  • Previous brain imaging research has shown that brain activity differs between pathological and non-pathological gamblers when exposed to wins, losses and near-miss outcomes. Mark R. Dixon, Ph.D., professor of rehabilitation at Southern Illinois University, was awarded $34,500 to examine the brain activity of disordered gamblers through an fMRI scanner before and after Acceptance and Commitment Therapy (ACT), an intervention that has shown promise for treating gambling disorders. The investigators will compare the brain scans of the therapy group with the control group to look for evidence of neurobiological changes as a result of ACT. According to Dr. Dixon, “This project will be the first in the published literature to a) document a magnitude effect of near-miss outcomes at the neurobiological level, and b) provide evidence at a neurobiological level of the impact of psychological treatment for pathological gamblers.”

Large Grants

  • Matthew P. Martens, Ph.D., associate professor in the department of educational, school and counseling psychology at the University of Missouri, Columbia, was awarded $172,500 to test a personalized feedback-only intervention that will provide “at-risk” college students with information about their own behavior. This project will determine if college students participating in the personalized feedback condition will report less gambling, fewer dollars gambled and less problem gambling at follow-up than students in both education/advice and assessment-only control conditions. According to Dr. Martens, “Our findings will indicate whether or not a low-cost, personalized feedback-only intervention is effective at reducing gambling-related activities and problems among college students at-risk for problem gambling.”
  • John Nyman, Ph.D., professor of public health at the University of Minnesota, was awarded $136,449 to study the differentiating factors between people who are recreational gamblers with no gambling-related problems and people who are pathological gamblers. Dr. Nyman explained, “There are a number of characteristics that have been associated with disordered gambling, such as race and gender. Our analysis will determine whether and to what extent these are also characteristics of recreational gambling. Isolating the characteristics that are associated with disordered gambling from those also associated with recreational gambling will permit more finely focused and effective interventions of disordered gamblers.” The study will also determine when a recreational gambler becomes a problem gambler. To achieve these objectives, Dr. Nyman’s team will conduct an analysis of two important data sets that include gambling data: the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), a nationally representative survey of 43,093 Americans and the Minnesota Twin Family Study.

Christine ReillyIssues & Insights

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New Edition Of The Wager Examines Study Of Personality Subgroups Of Pathological Gamblers

Scientists have proposed an understanding of pathological gambling (PG) as an expression of an underlying addiction syndrome (Shaffer et al., 2004). A syndrome, by definition, is expected to have generally predictable signs and symptoms, though they will vary and may not always be present. Are there definable “types” of people with PG? The most recent edition ofThe WAGER(Worldwide Addiction Gambling Education Report) reviews a study focused on this issue.

This month’s edition ofTheWAGER– Vol. 15(10)reviews a 2010 study published in theCanadian Journal of Psychiatrythat examined the personality variables of 1,171 people seeking treatment for PG in Spain (Alvarez-Moya et al., 2010). The researchers found four subgroups that were composed of people whose personality traits were more similar to each other than to others in the sample. These four groups had varying levels of psychological problems and PG severity with the most disordered meeting the most criteria for PG and the least disordered meeting the fewest PG criteria. For the full review or to access online reviews of research on other addictive disorders, visitThe BASIS (Brief Addiction Science Information Source).

As always, we welcome thoughts and questions in the comments section below.

References

Alvarez-Moya, E. M., Jiménez-Murcia, S., Aymamí, M. N., Gómez-Peña, M., Granero, R., Santamaría, J., Menchón, J. M., et al. (2010). Subtyping study of a pathological gamblers sample.Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie,55(8), 498-506.

Shaffer, H. J., LaPlante, D. A., LaBrie, R. A., Kidman, R. C., Donato, A. N., & Stanton, M. V. (2004). Toward a syndrome model of addiction: Multiple expressions, common etiology.Harvard Review of Psychiatry,12, 367-374.

NCRG staffIn the NewsBASISDivision on AddictionsDSMHarvard Medical Schoolnew research

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NCRG Awards $380,466 In New Research Grants

The National Center for Responsible Gaming (NCRG) recently announced it awarded $380,466 in project grants in 2010 for five new research projects on topics ranging from a laboratory simulation of Internet gambling to an intervention for college students at risk for developing gambling problems. The recipients of these grants are investigators based at the University of Florida, Duke University, Southern Illinois State University, University of Missouri and University of Minnesota. For more information and to view the press release, go the NCRG’swebsite.

NCRG staffICRG Newsgambling addictiongambling researchpathological gamblingproblem gambling

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December Issues &Amp; Insights Examines Motivational Interviewing For Gambling Addiction

Recovering from addiction is all about changing one’s behavior. Anyone who has tried to diet, quit smoking or get off the couch and exercise knows that changing behavior can be very challenging. It is especially true for individuals struggling with an addictive disorder. To assist people with changing their abuse of alcohol and drugs, specialists in addiction have developed motivational interviewing (MI), a widely disseminated clinical approach that uses a directive, client-centered counseling style for eliciting behavior change by helping clients to explore and resolve ambivalence about changing the addictive behavior (Miller & Rose, 2009). William R. Miller, Ph.D., Emeritus Distinguished Professor of Psychology and Psychiatry at the University of Mexico, led the development and testing of the original concept.

Research has shown successful outcomes when MI is employed by alcohol and drug counselors. But what about disordered gambling?This month’sIssues & Insightswill focus on the origins of motivational interviewing, its principles and how David Hodgins, Ph.D., professor of psychology at the University of Calgary in Canada, is testing this approach with disordered gamblers.

Miller, W. R., & Rose, G. S. (2009). Toward a theory of motivational interviewing.American Psychologist, 64(6), 527-537.

NCRG staffResearch Update

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The 10 Most Influential Research Papers On Gambling Disorders

One way to measure the success of a research study is to calculate its influence on the field.The Web of Scienceis an online index of peer-reviewed publications that monitors the number of times a particular article is cited in other publications. A count of how many times a paper is referenced can be used as a rough estimation of the impact of a study on the field, although it is not a measure of quality. What are the top 10 most influential research papers on pathological gambling (PG) from 1965 to the present? See the following list.

1. 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), 1184-8.

Times Cited: 659

The SOGS has been the most widely used screening tool for pathological gambling since it was first published in 1987. Screening tools often have very high citation counts because they provide a starting point for research on many diverging aspects of a subject.

2. Shaffer, H. J., Hall, M. N., & Vander Bilt, J. (1999). Estimating the prevalence of disordered gambling behavior in the United States and Canada: A research synthesis.American Journal of Public Health,89(9), 1369-76.

Times Cited: 266

This synthesis of findings from 119 other studies was the first in 20 years to provide national estimates of the prevalence of gambling disorders for the U.S. and Canada. The study was funded by the National Center for Responsible Gaming.

3. Petry, N. M., Stinson, F. S., & Grant, B. F. (2005). Comorbidity of DSM-IV pathological gambling and other psychiatric disorders: Results from the National Epidemiologic Survey on Alcohol and Related Conditions.Journal of Clinical Psychiatry,66(5), 564-74.

Times Cited: 165

The National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), the largest prevalence study of psychiatric disorders in the U.S., was one of the first major national health surveys to include questions about gambling. Face-to-face interviews were conducted during 2001 and 2002 with 43,093 U.S. residents aged 18 and older.

4. Dodd, M. L., Klos, K. J., Bower, J. H., Geda, Y. E., Josephs, K. A., & Ahlskog, J. E. (2005). Pathological gambling caused by drugs used to treat Parkinson disease.Archives of Neurology,62(9), 1377-1381.

Times Cited: 154

This exploratory study was one of the first to identify the connection between pathological gambling and a drug used to treat Parkinson’s Disease.

5. Cunningham-Williams, R. M., Cottler, L. B., Compton, W. M., & Spitznagel, E. L. (1998). Taking chances: Problem gamblers and mental health disorders–results from the St. Louis Epidemiologic Catchment Area Study.American Journal of Public Health,88(7), 1093-6.

Times Cited: 150

St. Louis, Mo., was one of five sites to participate in the Epidemiologic Catchment Area Study of mental disorders in the general population in 1981. This survey was among the first to provide substantial evidence for the high rate of co-occurring psychiatric disorders with pathological gambling.

6. McCormick, R. A., Russo, A. M., Ramirez, L. F., & Taber, J. I. (1984). Affective disorders among pathological gamblers seeking treatment.The American Journal of Psychiatry,141(2), 215-218.

Times Cited: 148

This study found a link between PG and affective disorders in a sample of participants in a gambling recovery program at a Virginia hospital.

7. Volberg, R. A. (1994). The prevalence and demographics of pathological gamblers: implications for public health.American Journal of Public Health,84(2), 237-241.

Times Cited: 147

This study of prevalence in five states found a lot of variation in the availability of gambling and prevalence of pathological gambling, while also finding that the demographics of people with PG were similar from state to state.

8. Blum, K., Sheridan, P. J., Wood, R. C., Braverman, E. R., Chen, T. J., & Comings, D. E. (1995). Dopamine D2 receptor gene variants: association and linkage studies in impulsive-addictive-compulsive behaviour.Pharmacogenetics,5(3), 121-141.

Times Cited: 139

This study is regarded as a watershed in the emerging study of the neurobiology of gambling disorders. The authors identified genetic variations in a particular neurotransmitter that is common among several disorders involving impulse control, such as pathological gambling, and coined the name “Reward Deficiency Syndrome” to describe this finding.

9. Sylvain, C., Ladouceur, R., & Boisvert, J. M. (1997). Cognitive and behavioral treatment of pathological gambling: a controlled study.Journal of Consulting and Clinical Psychology,65(5), 727-732.
Times Cited: 133

Cognitive-behavioral therapy (CBT) is one of the few treatments to show evidence of effectiveness for gambling disorders. This study was one of the early research projects to document the efficacy of CBT for pathological gambling.

10. Reuter, J., Raedler, T., Rose, M., Hand, I., Gläscher, J., & Büchel, C. (2005). Pathological gambling is linked to reduced activation of the mesolimbic reward system.Nature Neuroscience,8(2), 147-148.

Times Cited: 128

This study focused on the reward system of those with gambling problems and found similarities in brain chemistry between people with pathological gambling and alcohol/drug use disorders.

*The top 10 studies were identified by searching the Web of Science for the phrase “pathological gambling.” Two studies containing the phrase were excluded because they were not primarily focused on pathological gambling or pathological gamblers.

NCRG staffResearch Updategambling addictiongambling disordersgambling researchpathological gamblingWeb of Science

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