Prevention of youth gambling problems: Some important considerations

Jeffrey L. Derevensky, Ph.D.

Rina Gupta, Ph.D.

Laurie Dickson, M.A.

Anne-Elyse Deguire, M.Sc.

International Centre for Youth Gambling Problems and High-Risk Behaviors

McGill University

www.youthgambling.com

Annual Research Synthesis Conference on Pathological Gambling

Involvement in addictive behaviors

Total use Weekly use

Gr 7 Gr 9 Gr 11 Gr 7 Gr 9 Gr 11

Alcohol 36.8% 62.2% 79.8% 7.4% 14.0% 20.2%

Drugs 3.5% 13.4% 26.5% 2.7% 2.1% 9.0%

Cigarettes 18.2% 34.5% 48.4% 7.0% 16.1% 31.4%

Gambling 79.1% 78.9% 83.4% 30.4% 37.4% 37.1%

(Gupta & Derevensky, 1998a)

Nomenclature Hodge-Podge (Winters, 2001)

Problem Severity Continuum

No gambling

At-Risk

gambling

Social g

ambling

Problem gamblin

g

Pathologica

l gamblin

g

Compulsive gamblin

g

Habitual g

ambling

ProblemGambling

ConductDisorder

ADHD

DepressionDrug

Dependence

OtherDisorder

AlcoholDependence

Is Youth Problem GamblingA Primary Disorder?

Our current state of knowledge concerning youth gambling problems….

• Gambling is more popular amongst males than females (Derevensky, Gupta & Della Cioppa, 1996; Fisher, 1990; Govoni, Rupcich, & Frisch, 1996; Griffiths, 1989; Gupta & Derevensky, 1998a; Jacobs, 2000; Ladouceur et al., 1994; NORC, 1999; NRC, 1999; Stinchfield, Cassuto, Winters, & Latimer, 1997; Volberg, 1994, 1996, 1998; Wynne et al., 1996)

• Probable pathological gamblers are greater risk-takers (Arnett; 1994; Breen & Zuckerman, 1996; Derevensky & Gupta, 1996; Nower, Derevensky & Gupta, 2000; Powell, Hardoon, Derevensky, & Gupta 1999; Zuckerman, 1979, 1994; Zuckerman, Eysenck, & Eysenck, 1978)

• Adolescent prevalence rates of problem gamblers are 2-4 times that of adults (Gupta & Derevensky, 1998a; Jacobs, 2000; Shaffer & Hall, 1996)

• Adolescent pathological gamblers have lower self esteem compared with other adolescents (Gupta & Derevensky, 1998b)

• Adolescent problem gamblers have higher rates of depression (Gupta & Derevensky, 1998a,1998b; Marget, Gupta & Derevensky, 1999; Nower, Derevensky & Gupta, 2000)

• Adolescent problem gamblers dissociate more frequently when gambling (Gupta & Derevensky, 1998b; Jacobs, Marsten & Singer, 1985)

• Adolescents with gambling problems, ages 14-17, are at heightened risk for suicide ideation and suicide attempts (Gupta & Derevensky, 1998a)

• While adolescents with gambling problems report having a support group, old friends are often replaced by gambling associates (Derevensky, 1999; Gupta, 1999; Gupta & Derevensky, 2000)

• Adolescent problem gamblers remain at increased risk for the development of an addiction or polyaddictions (Gupta & Derevensky,1998a,1998b; Kusyszyn, 1972; Lesieur & Klein, 1987; Nower, Derevensky & Gupta, 2000; Winters & Anderson, 2000)

• Adolescent problem gamblers score higher on excitability, extroversion, and anxiety & lower on conformity and self-discipline (Gupta & Derevensky, 1997b,1998a; Vitaro, Ferland, Jacques & Ladouceur, 1998)

• Adolescents with gambling problems have poor general coping skills (Gupta, 1999; Kaufman, Derevensky & Gupta, 2002; Marget, Gupta, & Derevensky, 1999; Nower, Gupta & Derevensky, 2000)

• Adolescent problem gamblers report beginning gambling at earlier ages, approximately 10 years of age (Gupta & Derevensky,1997a,1998a; Wynne et al., 1996)

• Rapid movement from social gambler to problem gambler (Derevensky, 1999; Derevensky & Gupta, 1996, 1999; Gupta & Derevensky, 1998a)

• Pathological gamblers and youth in general report early gambling in the home and with family members (Derevensky & Gupta, 1997; Gupta & Derevensky, 1997a, 1997b)

• Problem and pathological gambling has been shown to result in increased delinquency and crime, disruption of familial relationships and decreased academic performance (Gupta & Derevensky, 1998a; Ladouceur & Mireault, 1988; Lesieur & Klein, 1987; Wynne et al., 1996)

• Pathological gamblers report greater major and minor life stressors (Gupta & Derevensky, 2002; Kaufman, Gupta & Derevensky, 2002)

• Problem and pathological gambling has been shown to have greater levels of trait and state anxiety (Ste-Marie, Gupta & Derevensky, 2002)

Profile of the adolescent problem gambler

• Predominantly male• Significant anxiety• Familial problems • Poor peer relationships• Preoccupation with gambling- reported inability to

stop despite repeated efforts• VLT, sports betting, lottery & scratch tickets, cards• Serious financial difficulties• Failure in school and/or at work• Lying to family and friends

Profile - continued

• Friends usually have similar gambling problems• Stealing from family, friends, stores, bank fraud, etc.• Depression or “feeling dead inside”• Gambling to escape and to feel better• General lack of coping abilities• Confused and conflicted about whether they really

want to stop gambling• Need for arousal or strong sensations

Alcoholabuse

SubstanceUse

TeenageSuicide

PathologicalGambling

Delinquency

FamilyEnvironment

Risk andProtective

Factors

CommunityEnvironment

Risk andProtective

Factors

School-RelatedRisk and

ProtectiveFactors

PeerAssociation

Risk andProtective

Factors

IndividualRisk and

ProtectiveFactors

SocietyRelated Risk

andProtective

Factors

Adapted from Understanding Substance Abuse Prevention: Toward 21st Century Primer on Effective Programs (P. Brounstein & J. Zweig, 1999). Centre for Substance Abuse Prevention (CSAP) & Substance Abuse and Mental Health Services Administration (SAMHSA)(Dickson, Derevensky & Gupta, 2002)

Prevention

Prevention can occur on three levels

• Primary prevention - targeting intervention to those who have not experienced a gambling problem.

• Secondary prevention - targeting those individuals demonstrating “at-risk” behaviors, inappropriate attitudes, and erroneous cognitions with respect to gambling.

• Tertiary prevention - treatment of those individuals currently experiencing a serious gambling problem.

Prevention• Focused around two concepts:

• risk & protection – and their interaction (Centre for Substance Abuse Prevention, 1999)

• Protective factors balance and buffer risk and ultimately lessen the likelihood of engaging in risk-taking behaviors or buffer exposure to problems (Hawkins, Catalano, & Miller, 1992)

• Shift in focused prevention to focus on resiliency (Garmezy & Streitman, 1974; Garmezy & Masten, 1986; Luthar, 1992; Jessor, 1998; Rutter, 1979; Werner, 1986)

• Education (Derevensky & Gupta, 1998a, 1999; Gupta & Derevensky, 1999, 2000)

Gambling PreventionPrevention through risk-reduction

– individual– family– peer and social contexts– community context

• Risk-reduction by enhancing protective factors– attributes of the individual– family support– environmental support

• Using schools as a basis for prevention through promotion of social/personal competence (Haggerty, Sherrod, Garmezy, & Rutter, 1994

A new conceptual model for the prevention of youth gambling

problems….

BIOLOGY /GENETICS SOCIALENVIRONMEN T

P ERCE IV EDENVIRONMEN T

P ERSON AL IT Y BEHA VIOR

Risk FactorsFamily History of AlcoholismMalePaternalpathologicalgambling

Protective Factors High Intelligence

Risk FactorsPovertyNormative AnomieRacial InequalityIllegitimate OpportunityAccess to gambling

VenuesReplacement of friends with

gambling associatesPositive media portrayal of

problem gambling

Protective FactorsQuality SchoolsCohesive FamilyNeighborhood ResourcesInterested Adults

Risk FactorsModels for Deviant BehaviorParent-Friends Normative Conflict

Protective FactorsModels for Conventional

BehaviorHigh Controls against

Deviant Behaviour

Risk FactorsLow Perceived Life

ChancesLow Self-EsteemRisk-Taking PropensityDepression and AnxietyHigh ExtroversionLow Conformity and self disciplineIncreased dissociationwhen gambling

Protective FactorsValue on AchievementValue on HealthIntolerance of Deviance

Risk FactorsProblem DinkingPoor School work School difficulties Poor coping skills Persisitent problem BehavioursEarly onset of gamblingexperiences

Protective FactorsChurchAttendance Involvement

in School and Clubs

Problem BehaviorIllicil Drug UseDelinquencyDrink-DrivingGambling ProblemsExcesive Alcohol

Health-Related BehaviorUnhealthy EatingTobacco UseSedentarinessNonuse of Safety Belt

School BehaviorTruancyDropoutDrug Use at School

HealthDisease/IllnessLowered Fitness

Social RolesSchool FailureSocial IsolationLegal TroubleEarly Childbearing

Personal DevelopmentInadequate

Self-ConceptDepression/

Suicide

Preparation for AdulthoodLimited Work SkillsUnemployabilityAmotivation

ADOLESCENT RISK BEHAV IORS/LIFEST Y LES

HEALT H/L IFE -COMP ROMIS ING OUT COMES

Red: factors specific to gamblingPurple: shared risk factors

Prevention Issues

• Abstinence

• Harm reduction/minimization

Using schools as a basis for prevention through promotion of social/personal competence (Haggerty, Sherrod, Garmezy, & Rutter, 1994)

at-risk vs. general population

target appropriate age groups with developmentally appropriate interventions

focus not merely on gambling but on social skills, coping abilities, & problem solving skills

Responsible prevention efforts include...

Incorporating knowledge acquired from scientific research

Taking a wide-angled approach (multi-faceted)

Adjusting the material to the developmental level of the recipient

Testing for program effectiveness PRIOR to widespread implementation

Conducting focus groups with teachers and children for input on program development and to evaluate teacher willingness to implement the prevention format

Goals of prevention

• Improve knowledge

• Increase awareness

• Change inappropriate attitudes and/or encourage positive attitudes

• Correct false cognitions, understandings, erroneous beliefs (odds, skill vs. luck, strategies, superstitions)

• Behavior - prevent occurrence of excessive gambling - decrease/reduce excessive gambling

patterns of behavior

• Increase problem-solving skills

• Increase feelings of self-confidence

• Improve coping skills

• Teach individuals to make good decisions for themselves in the face of peer pressure and social temptations

Note: Each level of prevention should be developmentally appropriate.

Key Elements

• Enhanced problem solving and thinking skills leads to more effective coping strategies

• Strategies to successfully resolve stressful life events• social skills• communication skills• decision-making skills• low sensation-seeking behaviors• feelings of success, self-worth and mastery

• Building of strong external resources• family• peers• school• community

Current Prevention Efforts

In development…

Other types of prevention

• Booths

• Presentations

• Workshops

• Responsible advertisements/ media messages

• Brochures, posters…

• Public policy advocacy

Additional Considerations

Public awareness, advertising, government responsibility, social policy

Government and Industry Role

“As state lotteries take on the social responsibility to help people who may have a problem with the product we offer, the lottery industry, as a whole benefits” Gerald Aubin, Executive Director, Rhode Island Lottery

“Lotteries should continue programs that discourage and prevent play by minors” NASPL policy statement in response to the NGISC report

• Children are strongly influenced by advertisements. The industry needs to be responsible and not glamorize gambling

• Just as there are advocates for responsible advertisement of alcohol and tobacco, we need monitoring of gambling advertisements

The need for responsible advertising

Enforcement of laws

– Penalties and serious fines for those who allow youth to have access to legalized gambling activities

Positive initiatives…• Support for public service announcements

• Support for anti-youth gambling advertisements and programs

• Education

• Sales force

• Public

• Development and enforcement of regulations and statutes

• Strict penalties for non-compliance

• Provide support for telephone hot lines and print numbers on back of lottery tickets

• Establishment and funding of internal departments dedicated toward promoting responsible gaming and helping gaming problems

• Specific programs designed for youth gambling

– Notices on retailer employee bulletin boards

– Statements on play slips and lottery tickets

– Visible signs on lottery booths and ticket machines

– Developing and providing appropriate materials to schools

Gambling: the silent addiction…….

International Centre for Youth GamblingProblems and High-Risk Behaviors

Centre international d’étude sur le jeuet les compertements à risque chez les jeunes

www.youthgambling.com

Understanding

ThroughKnowledge