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The relationship between age of gambling onset and adolescent problematic gambling severity

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By using our site, you agree to our collection of information through the use of cookies. To learn more, view our Privacy Policy. To browse Academia. Due to the increase in accessibility and opportunities to gamble, a large body of research has shown that increasing numbers of adolescents engage in gambling e. Surveys in the United States reveal that participation in card games, sports betting, games of skills, and video lottery terminals are most common in youth e. In order to determine the extent of problem gambling in different population segments, Shaffer and Hall conducted a meta-analysis and summarized distinct estimates from North American prevalence studies, including 32 samples with adolescents. Their calculations demonstrate a lifetime rate for pathological gambling level 3 gambling in adolescence of 3. European prevalence studies also have identified small but significant number of adolescents can be classified as problem gamblers e. Despite methodological inconsistencies, these prevalence studies highlight the growing need a to introduce effective prevention programs for adolescents to diminish the incidence of problem adolescent gambling and b to implement appro- priate treatment facilities for adolescents to avert further maladaptive outcomes and foster a behavioral change. Eight-hundred and seventeen adolescent high school students in the Montreal region completed the DSM-IV-J gambling screen along with a questionnaire devised by the authors inquiring about their gambling behavior, including items assessing the types of activities in which they engage, frequency of involvement, reasons for gambling, and their cognitive perceptions of gambling activities. The results indicate that, in general, Adolescents reported participating in gambling behavior more often than any other addictive behavior, including cigarette smoking, alcohol consumption, and illicit drug use. The mean age of onset of gambling behavior for the sample was The rate of pathological gambling was 4. Pathological gamblers were more likely to have parents with gambling problems and to be engaging in illegal activities than non-pathological gamblers. Gender differences were evident, with males engaging in gambling activities more than females. Differences in game preferences were found, with males more attracted to sports lottery tickets and sports pool betting and females more attracted to lottery tickets and bingo. Gambling awareness and prevention issues are addressed. Little is known about the course and outcomes of adolescent gambling. This prospective study describes findings from a 3-wave Time 1 \[T1\], Time 2 \[T2\], and Time 3 \[T3\] assessment of gambling behaviors among youth N Stable rates of any gambling and regular gambling While there is a general consensus in the literature that it is common for youth to gamble, considerable variability in the reported prevalence rates of youth problem gam-bling has been found. More recently, issues concerning the possible overestimation of these rates have been raised. Arguments underlying the proposition that problem gam-bling rates for youth are inflated are examined. It is acknowledged that more rigorous research is required, including the need for the development and refinement of cur-rent adolescent instruments and screening tools, agreement upon a gold standard cri-terion for adolescent problem gambling, and clarity of nomenclature issues. The ad-vancement of scientific knowledge concerning the underlying risk factors associated with the onset and course of youth gambling involvement and the role of effective adolescent prevention and treatment programs will require these fundamental re-search questions to be addressed. Revue d'Histoire de l'Eglise de France, Log in with Facebook Log in with Google. Remember me on this computer. Enter the email address you signed up with and we'll email you a reset link. Need an account? Click here to sign up. The relationship between age of gambling onset and adolescent problematic gambling severity Loreen Rugle. Related papers Griffiths, M. Adolescent gambling: Risk factors and implications for prevention, intervention, and treatment. Romer Ed. London: Sage. Mark D Griffiths. Hayer, T. The prevention and treatment of problem gambling in adolescence. Adams Eds. Handbook of adolescent behavioral problems: Evidence-based approaches to prevention and treatment. New York: Springer. A prospective study of youth gambling behaviors Ken Winters. Predictors of adverse gambling related consequences among adolescent boys Neven Ricijas. Prevalence rates of youth gambling problems: are the current rates inflated Ken Winters. Rahman a, Corey E. Pilver b, Rani A. Desai a, c, Marvin A. Post-hoc analysis revealed that earlier-onset ARPG was more strongly associated with multiple forms of non-strategic gambling including lottery instant, traditional and slot-machine gambling. The extent to which non-strategic forms of gambling may serve as a gateway to other forms of gambling or risk behaviors warrants additional study, and efforts targeting youth gambling should consider how best to address non-strategic gambling through education, prevention, treatment and policy efforts. All rights reserved. Introduction Gambling is common with over two-thirds of the U. Most adults gamble without problems, although an estimated 12 million individuals experience either problematic or pathological gambling PPG; Lynch et al. Adult PPG has been associated with substance use problems, legal troubles, and poor physical and mental health Barry et al. Yale School of Medicine, 1 Church St. E-mail address: marc. Adolescence is a developmental period marked by high impulsivity, risk taking, and vulnerability to addiction, all of which can persist into adulthood Auger et al. Consistently, when compared to adult populations, adolescents may be two to four times more likely to experience gambling problems Burge et al. Rahman et al. Age of gambling onset may represent an important distinguishing feature in PPG as in substance use disorders. Early age of onset of alcohol use has been linked to later-life substance use, other risk behaviors and adverse measures of life functioning Chou and Pickering, ; DeWit et al. Similarly, early age at gambling onset may be predictive of future problems as it associates with adult problems including substance use disorders, depression and other psychiatric concerns Grant et al. In another study, early onset adult PPG was associated with suicidal ideation, early onset of alcohol use, and prior substance abuse treatment Burge et al. Felsher et al. As earlier-onset gambling has been linked to lottery gambling, a nonstrategic form of gambling, the extent to which this type of gambling may associate to risky or problematic gambling in youth warrants further investigation. In this study, a lower threshold for problem gambling severity individuals reporting or one or more inclusionary criteria for pathological gambling was employed to examine gambling behaviors. To better understand and characterize adolescent PPG is crucial as it may be the most opportune time to prevent further development of the pathology Wilber and Potenza, To examine these questions, we utilized data from a cross-sectional survey that assessed risk behaviors in Connecticut high school students; these data have been used previously to investigate correlates of problem gambling severity in general Yip et al. However, prior research with these data did not consider age of onset of gambling behavior in relation to health, functioning, and gambling measures. We hypothesized that the prevalence of ARPG would be greater among adolescents who reported an earlier-onset of gambling. Furthermore, we hypothesized that problem gambling severity would be more strongly associated with poorer academic performance, substance use, depression, and aggression in early onset gamblers, compared to late onset gamblers. Methods 2. Participants The recruitment and description of participants are as previously described Cavallo et al. Schools were offered an assessment of the risk behaviors associated with their respective student bodies as incentive for participation. DRGs are based on the socio-economic status of the households comprising those districts and were included in this survey to account for the socio-economic differences between the various schools. Procedure A passive consent procedure was utilized to obtain parental permission. Letters were mailed to parents outlining the study and those who did not want their child participating in the study were asked to contact the school directly. If no contact was made, then parental consent was assumed. Students were also given the option of not participating if they so desired. This consent procedure was approved by the participating schools as well as the Institutional Review Board of the Yale University School of Medicine. Students were given pens for the survey and instructed not to write any identifying information on the survey. Students were informed that participation was voluntary. Individuals wishing not to participate or those students not given consent by their parents were instructed to sit quietly and complete other work. The survey consisted of questions concerning demographic characteristics, gambling activity, substance use, and other risk behaviors. Other drug use e. A study conducted by Winters et al. Data analysis Individuals were selected for inclusion in the study if they provided valid data for the age-of-gambling-onset question, as well as responses to all twelve of the DSM-IV gambling questions. A total of participants were administered the questionnaire. For this study, students were included that completed the gambling sections of the questionnaire, answered all 12 DSM-IV gambling questions, and indicated an age of gambling onset. All data were double-entered, reviewed to ensure withinrange values, and randomly spot-checked to verify accuracy. Two-tailed, Pearson chi-square analyses were used to compare earlier-onset and later-onset gamblers. To determine whether age of gambling onset moderated these relationships, we utilized the entire sample and included the main effects for age of onset and gambling problem severity, as well as the interaction term age-of-onset-by-problemgambling-severity in the appropriate logistic or multinomial logistic regression model. All models were adjusted for age, race, gender, and household structure. Results 3. Health and well-being measures Chi-square Table S1 and logistic regression Table 2 analyses examining the relationships between problem gambling severity and health and well-being measures by gambling group earlier- vs. Chi-square analyses tabulated frequencies for respondents on the given variables while logistic regression was used to understand the association between these variables and the different gambling groups. Gambling measures The relationships between ARPG and gambling motivations and behaviors according to age of onset are presented Table 3, S2. Results for anxiety relief in later-onset gamblers were unstable due to low cell size. Discussion 4. Summary of study This study examined the correlates of ARPG as related to age of gambling onset amongst a sample of adolescents. These associations are not fully understood within an adolescent group, though studies suggest that pre-adolescent onset of gambling is associated with ARPG during adolescence Lynch et al. Accordingly, this investigation hypothesized that there would be a higher frequency of ARPG individuals in the earlier-onset group. Analyses supported this hypothesis. The data did not support this hypothesis as interaction odds ratio indicated similar associations with ARPG across earlier- and later-onset groups. Third, this study hypothesized that earlier-onset ARPG would be more strongly associated with non-strategic gambling types when compared to later-onset ARPG, and this hypothesis was supported. Overall, results from this study indicate that the correlates of ARPG are largely similar for earlier- and later-onset gamblers. An exception, however, exists for gambling type in which earlier-onset ARPG is more strongly associated with engagement in non-strategic forms of gambling, with post-hoc analyses suggesting contributions from a broad range of non-strategic forms of gambling. Additionally, a more recent study showed that two of most frequently reported forms of gambling amongst children and young adolescents youth ages 10e14 years from Colombia were slot machines and scratch cards Zapata et al. The extent to which non-strategic gambling may have a broad appeal to children whose strategic abilities have not yet fully developed warrants consideration, as do the extent to which other behaviors e. It may be possible that non-strategic gambling represents an early developmental behavior that increases risk for later adolescent problematic gambling. While the current cross-sectional results can address the correlative nature of non-strategic gambling and ARPG, a longitudinal study may facilitate the temporal role of how nonstrategic gambling relates to ARPG. ARPG and age of gambling onset 4. Prevention strategies The results of this study show that ARPG is more frequent amongst earlier-onset adolescent gamblers than amongst lateronset adolescent gamblers. The strengths of the relationships between ARPG and gambling attitudes and behaviors were also largely similar amongst earlier- and later-onset gamblers. For example, greater likelihoods of participation in strategic forms of gambling by ARPGs were observed in both earlier- and later-onset gamblers. Similarly, ARPGs in both Consideration of types of gambling may be particularly important in developing improved treatment and prevention strategies for youth. Some studies suggest that forms of non-strategic gambling may lead to a more rapid development of gambling pathology Dowling et al. Possible factors that may relate to rapid progression may include rapidity of action of some forms e. Educational efforts aimed at parents and educators may help diminish underage both child and adolescent involvement in non-strategic forms of gambling. Policy interventions e. However, despite the potential impact of such prevention and policy efforts, the effectiveness of these approaches requires empirical validation that is currently lacking. The post-hoc analyses of earlier-onset gamblers indicated that ARPG was associated with all assessed forms of non-strategic gambling. First, better educating parents and adults on the potential harms of nonstrategic gambling could help curtail underage gambling. When children observe their parents or other prominent adults engage in non-strategic gambling, it may leave the impression that these forms of gambling are not harmful or not as harmful as others. Educating parents as well as adolescents themselves may help reduce non-strategic gambling amongst youth. Integrating gambling awareness e. Under current Connecticut law 18 CGS x d , minors are not permitted to purchase lottery tickets themselves, but are allowed to receive them as gifts from adults. Future prevention strategies should consider increasing awareness amongst these establishments on the potential harms of underage gambling in order to minimize this avenue of engagement. Reviewing, potentially revising, and better enforcing the legal penalties associated with violating establishments could help reduce these types of non-strategic gambling amongst youth. Similarly, efforts to reduce underage gambling in both casino and non-casino venues deserve attention as the legal age in Connecticut for participation in other forms of gambling e. Limitations and conclusion Limitations exist in this study. First, while ecologically valid, the sample was not random. Some DRGs were selected in order to get a more representative sample of the state. Second, the crosssectional design limits the ability to observe how variables may change throughout adolescence and into adulthood, or from childhood to adolescence. Observing how gambling attitudes and behaviors may change from adolescence to adulthood, as in a longitudinal study, could provide insight and better inform long-term prevention and treatment strategies. Such longitudinal studies should include assessments not only of gambling behaviors, but also of intermediary phenotypes including those like impulsivity that have been shown at early ages e. Third, precise data on frequencies of gambling were not collected. Considering the frequency of gambling could provide further insight with regards to prevention strategies. However, this issue is complex in that frequencies of different forms of gambling e. Fourth, the data collected were based on student recall, which is subject to potential biases and inaccuracies. Fifth, the relatively low proportion of individuals with pathological gambling in the sample precluded the focused study of this clinically relevant group. Sixth, other important differences e. Lastly, the earlier- and later-onset gambling groups were not evenly matched in size, with the earlier-onset group being approximately twice as large as the later-onset group. However, the large difference in the groups also indicates that earlier-onset gambling is a frequent occurrence amongst adolescents, which is important to note. Furthermore, the categorical assessments of some variables e. Contributors Drs. Desai, Krishnan-Sarin and Potenza were responsible for participant recruitment, data collection, and managing the experimental design of this study. Marvin Steinberg provided input on the study questionnaire. Pilver and Desai designed and conducted data analyses. Rahman, with Dr. All authors, including Dr. He has participated in surveys, mailings, or telephone consultations related to drug addiction, impulse control disorders, or other topics. He has performed grant reviews for the National Institutes of Health and other agencies. Acknowledgments We would like to thank Dr. We would also like to thank the survey participants and the members of the research group who collected the data. Supplementary material Supplementary material associated with this article can be found, in the online version, at doi Impulsivity and socio-economic status interact to increase the risk of gambling onset among youth. Addiction ; e Journal of Psychiatric Research ; e Blaszczynski A, Nower L. A pathways model of problem and pathological gambling. Addiction ;e Age of gambling initiation and severity of gambling and health problems among older adult problem gamblers. Psychiatric Services ;e9. Journal of Gambling Studies ;e International Journal of Mental Health and Addiction; e Smoking expectancies, weight concerns, and dietary behaviors in adolescence. Pediatrics ;e66e Developmental neurocircuitry of motivation in adolescence: a critical period of addiction vulnerability. 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Psychological experience of gambling and subtypes of pathological gamblers. Psychiatry Research ;e Problematic Internet use and health in adolescents: data from a high school survey in Connecticut. Journal of Clinical Psychiatry ;e How psychological symptoms relate to different motivations for gambling: an online study of internet gamblers. Biological Psychiatry ;e Psychiatric correlates of gambling in adolescents and young adults grouped by age at gambling onset. Archives of General Psychiatry ;e Nower L, Blaszczynski A. Characteristics of problem gamblers 56 years of age or older: a statewide study of casino self-excluders. Psychology and Aging ; e Strategic vs nonstrategic gambling: characteristics of pathological gamblers based on gambling preference. Excitement-seeking gambling in a nationally representative sample of recreational gamblers. Pathological gambling. JAMA a; e4. Gender-related differences in the characteristics of problem gamblers using a gambling helpline. 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