Journal ID (publisher-id): jgi
Publisher: Centre for Addiction and Mental Health
© 1999-2005 The Centre for Addiction and Mental Health
Publication date: September 2005
Publisher Id: jgi.2005.14.11
|Gambling problems in youth: Theoretical and applied perspectives|
|Affiliation: Victoria University, Melbourne, Victoria, Australia. E-mail: email@example.com
|[This article prints out to about six pages.]
This review was not peer-reviewed. Submitted: March 8, 2005.
For correspondence: Keis Ohtsuka, Victoria University, Melbourne, Victoria, Australia. E-mail: firstname.lastname@example.org
This collection of specialist papers on the current state of youth gambling research summarises the progress in youth problem gambling research in recent years. Theories on youth problem gambling have evolved to a point where research evidence once perceived as contradictory and subject to debate can be reconciled within a more general theoretical framework. Growing consensus makes possible a synthesis that can inform public policy.
Youth gambling is no longer a novelty. More than 20 years have passed since concerns were raised regarding the increased availability of legalised gambling in industrialised democracies. A generation of youth has since grown up in a gambling-friendly environment. Over this period, substantial research evidence on youth gambling has also been accumulated, enabling us to refine theories regarding the genesis, maintenance, and treatment of youth problem gambling.
This timely volume, edited by Jeffrey L. Derevensky and Rina Gupta (International Centre for Youth Gambling Problems and High-Risk Behaviors, McGill University) summarises the current state of youth gambling research. This book synthesises research findings on youth problem gambling with the aim of achieving a better overall understanding. It is encouraging that theories on youth problem gambling have evolved to a point where research evidence that was once perceived as contradictory and subject to debate can be reconciled within a more general theoretical framework. In particular, what were once competing explanations for youth problem gambling (e.g., Jacobs's general model of addiction vs. the cognitive/behavioural model of youth gambling) are now increasingly understood as equally valid causal explanations for different types of problem gamblers. Growing consensus makes possible a synthesis that can inform public policy. Collective research efforts on youth problem gambling are making progress, although more work is ahead of us.
Jacobs (Chapter 1) provides an up-to-date general overview of youth problem gambling in North America. He warns that the increase in youth problem gambling may be a linear function of gambling availability. Given the lack of reliable predictive models, his prognosis is a starting point for further debate. One thing is clear: we need to monitor the prevalence of youth problem gambling, anticipate its increase, and allocate resources for assistance and treatment. The development of accurate demographic, psychological, and behavioural prediction models is also necessary.
In Chapter 2, Stinchfield discusses the risk and protective factors of youth problem gambling. Analysing demographic, behavioural, and psychological correlates, he conceptualises youth problem gambling as a subclass of youth deviant behaviours. Males who exhibit antisocial behaviour, smoke, drink alcohol, and use drugs, with a history of parental/familial gambling, school problems and failure, and peer deviance, are consistently subject to youth problem gambling. Stinchfield recommends careful appraisal of causal and predictor relationships between the risk and protective factors of youth problem gambling and research on their effectiveness in prediction. He also argues for the integration of youth problem gambling models with the more general model of adolescent risk-taking behaviour.
Depression, anxiety, and youth suicide often accompany youth problem gambling. Langhinrichsen-Rohling (Chapter 3) proposes an integrated model of the association between gambling and depression and suicidal behaviour in youth. However, she cautions that the same processes may not fully explain the occurrence of addiction in adolescents and the elderly, in males vs. females, or in people from different socioeconomic backgrounds. Winters, Arthur, Leitten, and Botzet (Chapter 4) propose three pathways to co-occurrence of substance abuse and problem gambling behaviour. They propose that youth problem gambling be defined as a subclass of addictive behaviours. Research evidence so far clearly shows that youth problem gambling should not be regarded as just a benign non-life-threatening truancy. It occurs with a wide range of youth deviance behaviours, including substance addiction, as well as depression and anxiety leading to suicidal behaviour.
Grant, Chambers, and Potenza (Chapter 5) review the neurological aetiology of youth problem gambling and pharmacological treatment. This chapter is an informative introduction to readers who work with youth problem gamblers with emotional vulnerability and impulse control disorder. To treat this group of impulsivist youth problem gamblers, a team of psychologists and psychiatrists may need to coordinate psychological and pharmacological intervention. Youth embrace novel things and adapt easily to new technology. E-mail and Internet chat supplement the telephone in young people's need to get in touch with peers on regular basis. Some youth exhibit an excessive use of new technology, which may be classified as addiction. Griffiths and Wood (Chapter 6) discuss the relationship between technology, such as video game playing and Internet surfing, and youth gambling. Undoubtedly, behavioural addiction such as gambling shares many common features with similar types of behavioural addiction, such as excessive video game playing and Internet use. Along with the increased availability of new technology, the percentage of youth showing worrying signs of addiction to such technology would also increase. Another concern is that young people may misapply expertise in video games (skill-based activities) to gambling (chance-governed activity). Langer (1975) argues that misapplication of skill-based approaches to gambling contributes to the illusion of control beliefs and overoptimistic expectations of winning at gambling. Beliefs in the illusion of control are predictive of gambling frequency as well as of problem gambling (Moore & Ohtsuka, 1999).
Derevensky and Gupta (Chapter 7) review screening instruments of youth problem gambling. Most screening instruments are based on the DSM-III or IV definition of pathological gambling. They include a preoccupation with gambling, a lack of adequate control over one's gambling behaviour, and an inability to stop gambling; guilt, withdrawal symptoms, and difficulties in one's social life; and work/school failure. Differences exist in terms of sensitivity and in the rate of false positives. Perhaps the notion of a progressive disorder, multiple pathways to youth problem gambling, and a theoretical framework that regards problem gambling as a constellation of disorders need to be incorporated in order to accurately assess youth problem gambling. It is suggested that incorporating immediate feedback into screening instruments should maximise the effectiveness of youth education.
The Transtheoretical Model (TTM) of Intentional Behavior Change (DiClemente & Prochaska, 1998; Prochaska & DiClemente, 1994), originally developed as a model of smoking cessation, explains a wide range of individual behavioural change such as the recovery process from substance abuse, exercise, and weight control (DiClemente, Delahanty, & Schlundt, Chapter 8). Five stages are required to effect any permanent behavioural change: precontemplation (not considering behavioural change), contemplation (seriously considering change), preparation (preparing to change), action (performing actual behavioural change), and maintenance (sustaining the behavioural change over time). TTM also advocates a focus on markers of change. As well as strengthening protective factors, cognitive-behavioural therapists working with youth need to ensure that their decision-balance is in favour of curtailing gambling and that their self-efficacy is strengthened to ensure successful treatment outcomes.
Gupta and Derevensky (Chapter 9) and Nower and Blaszczynski (Chapter 10) identify three groups of youth problem gamblers: (a) behaviourally conditioned problem gamblers, (b) emotionally vulnerable problem gamblers, and (c) antisocial impulsivist problem gamblers. Gambling initiation and maintenance mechanisms differ among the three groups—hence the need for different treatment plans for each group. A pathways approach to treatment is applicable to a wide continuum of youth problem gamblers—starting with behaviourally conditioned youth on one end of the spectrum, those with emotional vulnerability in the middle, and impulsive youth with emotional vulnerability on the extreme end of the scale.
The book concludes with chapters on prevention aimed at reducing gambling problems (Derevensky, Gupta, Dickson, & Deguire, Chapter 11) and socially responsible policy (Derevensky, Gupta, Messerlian, & Gillespie, Chapter 12). Empirical research on risk and protective factors as well as a more comprehensive theoretical framework identifying youth problem gambling in a general theory of youth deviance would facilitate multiple approaches to youth gambling reduction.
Socially responsible policy is arguably one of the least developed areas of youth gambling research. While our psychological and clinical understanding of youth problem gambling can be applied to alleviate existing problems, our knowledge can be equally useful in assisting socially responsible policy making: this is a proactive rather than a reactive policy.
We know considerably more about youth gambling initiation, maintenance, treatment, risk, and protective factors—be they psychological or demographic—than we did 10 years ago. We need more research on the role of gambling in society and within communities; on its impact upon the national economy, at both the macro and the micro levels; and on the meaning, function, and symbolic experience of gambling, as well as research on resilience, treatment efficacy, and preventive education. Examining the phenomenological experience and meaning of the addiction for the individual helps us to understand the causes of underlying distress beyond the manifestations of problem gambling. The next challenge for researchers and policy makers, as well as for members of the general community, is to apply what we have learned through research directly to socially responsible policy making.
|DiClemente, C.C.. Prochaska, J.O.. ( 1998). Toward a comprehensive, transtheoretical model of change: Stages of change and addictive behaviour. In Miller, W.R.. & Heather, N.. (Eds.), Treating addictive behaviors (2nd ed., pp. 3–24). New York: Plenum.|
|Langer, E.. ( 1975). The illusion of control,Journal of Personality and Social Psychology, 32, 311-328.|
|Moore, S.M.. Ohtsuka, K.. ( 1999). Beliefs about control over gambling among young people, and their relation to problem gambling. Psychology of Addictive Behaviors, 13, 339-347.|
|Prochaska, J.O.. DiClemente, C.C.. ( 1994). The transtheoretical approach: Crossing traditional boundaries of therapy. Malabar, FL: Kreiger.|