Are poker players all the same? : latent class analysis

Poker is the gambling game that is currently gaining the most in popularity. However, there is little information on poker players' characteristics and risk factors. Furthermore, the first studies described poker players, often recruited in universities, as an homogeneous group who played in only one of the modes (land based or on the Internet). This study aims to identify, through latent class analyses, poker player subgroups. A convenience sample of 258 adult poker players was recruited across Quebec during special events or through advertising in various media. Participants filled out a series of questionnaires (Canadian Problem Gambling Index, Beck Depression, Beck Anxiety, erroneous belief and alcohol/drug consumption). The latent class analysis suggests that there are three classes of poker players. Class I (recreational poker players) includes those who have the lowest probability of engaging intensively in different game modes. Participants in class II (Internet poker players) all play poker on the Internet. This class includes the highest proportion of players who consider themselves experts or professionals. They make a living in part or in whole from poker. Class III (multiform players) includes participants with the broadest variety of poker patterns. This group is complex: these players are positioned halfway between professional and recreational players. Results indicate that poker players are not an homogeneous group identified simply on the basis of the form of poker played. The specific characteristics associated with each subgroup points to vulnerabilities that could potentially be targeted for preventive interventions

La crise chez les joueurs de jeux de hasard et d’argent : au-delà de l’appel de détresse, les services novateurs qui y répondent

La dynamique des joueurs excessifs a souvent pour conséquence d’affecter les relations affectives, l’emploi, la santé financière de la famille de même que la santé mentale et physique de la personne. Ces multiples répercussions personnelles et professionnelles accentuent la détresse déjà très importante chez les joueurs. Or, la détresse conjuguée à de multiples petits événements stressants crée un terrain propice à l’émergence d’une multitude de crises psychosociales. À partir d’une recension des écrits, cet article présentera d’abord les liens complexes entre la crise et le jeu. Ensuite, une présentation critique des différents services de crise pour les joueurs (lignes d’écoute, services d’intervention de crise dans les casinos et service d’autoexclusion) sera effectuée. Enfin, nous conclurons par des recommandations pour améliorer les services actuels.The dynamic of pathological gamblers often impacts their affective relationships, employment and the family’s financial health, as well as the person’s mental and physical health. These multiple personal and professional repercussions accentuate the gambler’s already significant distress. This distress, combined with many little stressful incidents, creates a fertile ground for the emergence of multiple psychosocial crises. Based on the documentation, this article begins by presenting the complex relationship between the crisis and gambling, followed by a critical presentation of the various crisis services for gamblers (hotlines, crisis intervention services in the casinos and self-exclusion service). Lastly, recommendations on how to improve current services are made.La dinámica de los jugadores excesivos afecta a menudo como consecuencia las relaciones afectivas, el empleo, la salud financiera de la familia y la salud mental y física de la persona. Estas múltiples repercusiones personales y profesionales acentúan el desamparo, que es ya muy importante en los jugadores. Ahora bien, el desamparo conjugado con múltiples pequeños acontecimientos estresantes crea un terreno propicio para el surgimiento de una cantidad de crisis psicosociales. A partir de una revisión de textos, este artículo presentará en primer lugar los vínculos complejos entre la crisis y el juego. Continuará luego con la presentación crítica de los diferentes servicios de crisis para jugadores (líneas de escucha, servicios de intervención de crisis en los casinos y servicio de auto-exclusión). Finalmente, concluirá con recomendaciones destinadas a mejorar los servicios actuales

L’efficacité des programmes de prévention de la toxicomanie axés sur les familles

Cette recension des écrits examine l'efficacité de programmes de prévention des toxicomanies auprès des familles. De nombreux travaux soulignent le rôle déterminant des familles dans la transmission des habitudes de consommation. De plus, selon plusieurs intervenants, la famille constitue un milieu propice pour l'instauration de tels programmes de prévention. Cet article propose une analyse critique de ces programmes. Sont présentés les facteurs de risque liés à l'abus de substances chez les jeunes, puis les programmes visant la famille dont la stratégie est l'information, ceux qui font appel à des stratégies multiples et ceux qui visent les parents les plus à risque. Une critique méthodologique des études évaluatives est présentée. Les auteurs concluent par des recommandations.This literature review examines the efficiency of drug addiction prevention programs centered on families. Many studies underline the determining role of families in the transmission of consumption habits. Moreover, according to many intervenors, the family constitutes a favourable milieu to institute these prevention programs. This article proposes a critical analysis of these programs. The risk factors related to substance abuse with youth are first presented followed by information strategy programs aimed at families, multiple-strategy programs as well as programs aimed at parents who are considered at high risk. A methodological review of evaluative studies is presented. The authors conclude with recommendations.Este censo de escritos examinarâ la eficacia de los programas de prevenciôn con las familias, de la toxicomania. Numerosos trabajos subrayan el papel déterminante de las familias en la transmisiôn de hâbitos de consumo. Ademâs, segun varios trabajadores, la familias constituye un medio propicio para la instauration de taies programas de prevenciôn. Este artïculo propone un anâlisis crîtico de esos programas. En principio se presentan los factores de reisgo ligados al abuso de sustancias en los jôvenes y después los programas hacia las familias cuya estrategia es la information, aquellos que Uaman a estrategias multiples y aquellos dirigidos hacia los padres a riesgo. Una critica metodolôgica de los estudios es presentada. Los autores concluyen con recomendaciones

Correlates of at-risk gambling behaviors of homeless youth

Objective: This exploratory study aims to describe the gambling behaviors of 419 homeless youth. Methods: Participants were divided into two groups: 1) those whose gambling behaviors did not present a risk (n=366); and 2) those whose gambling behaviors presented a risk (n=53). Results: In this homeless youth cohort, 12.6% exhibited gambling behaviors that could be considered at-risk. Compared to youth not having at-risk gambling behavior, youth with at-risk gambling behaviors were more likely to be male and be born outside of Canada. The at-risk participants were three times more likely to have a diagnosis of mental health disorder and two times more likely to report criminal activities as their main source of income. Conclusions: These findings underline the importance of addressing all at-risk behaviors engaged in by homeless youth

Tour d’horizon sur les principales approches de traitement du jeu pathologique chez les adultes et les adolescents

L’industrie des jeux de hasard et d’argent a connu un essor important au cours des dernières années. Parallèlement, les gouvernements ont beaucoup investi dans la recherche et le développement de programmes de traitement afin d’aider les joueurs aux prises avec un problème de jeu. Bien que l’offre de traitement soit diversifiée, on ne dispose pas actuellement de données probantes permettant de statuer sur les meilleures pratiques en matière de traitement du jeu pathologique. Les études évaluatives qui ont été menées auprès de joueurs pathologiques comportent des failles méthodologiques. Néanmoins, certaines approches chez les adultes semblent prometteuses. Par exemple, l’approche cognitivo-béhaviorale et les groupes de soutien de type Gamblers Anonymes (GA) se démarquent en termes de maintien de l’abstinence au jeu. D’autres travaux récents présentent des résultats encourageants obtenus avec l’approche pharmacologique. L’administration de Naltrexone aux joueurs pathologiques permettrait de diminuer l’envie obsessive de jouer. On commence aussi à reconnaître que le modèle transthéorique du changement et l’approche de thérapie conjugale contribuent certainement à améliorer la rétention des joueurs adultes en traitement. Pour les adolescents, l’offre de traitement est moins développée. Les initiatives de programmes d’intervention pour les jeunes présentant un problème de jeu sont encore embryonnaires et empruntent généralement les paradigmes de l’approche cognitivo-béhaviorale. Il sera nécessaire aussi de réfléchir aux critères retenus correspondant à la réussite d’un traitement, que ce soit pour les adultes ou pour les adolescents. L’abstinence complète de tous les jeux de hasard et d’argent n’est peut-être pas le seul indicateur de rétablissement.The gaming industry has expanded considerably over the past years. During this time, governments have invested a lot in research and development for treatment programs to help problem gamblers. Despite the diversity of treatments offered, there are currently no data that enable us to determine the best practises in terms of treatment for pathological gambling. There are methodological flaws in the evaluative studies involving pathological gamblers, so treatment effectiveness cannot be determined. Nevertheless, some approaches used with adults appear promising. Notably, the cognitive behavioural approach and Gamblers Anonymous (GA) support groups stand out in terms of maintaining abstinence from gambling. Other recent research shows encouraging results using the pharmacological approach. It appears that administering Naltrexone to pathological gamblers would help reduce the obsessive desire to gamble. Also gaining recognition is the definite contribution of the transtheoretical model of change and couple-therapy approaches to keeping gamblers in treatment. For adolescents, treatment options are less developed. Intervention program initiatives for youths exhibiting a gambling problem are still at the embryonic stage and borrow paradigms from the cognitive behavioural approach. Thought must be given to determining which criteria correspond to the success of a treatment, whether for adults or adolescents. Complete abstinence from all gambling may not be the only indicator of recovery.La industria de los juegos de azar y de dinero ha tenido un progreso importante en los últimos años. Al mismo tiempo, los gobiernos han invertido mucho en la investigación y el desarrollo de programas de tratamiento destinados a ayudar a los jugadores que se enfrentan con un problema de juego. Si bien la oferta de tratamiento es diversificada, no se dispone en la actualidad de datos convincentes que permitan determinar cuáles son las mejores prácticas en materia de tratamiento del juego patológico. Los estudios de evaluación que se han llevado a cabo con jugadores patológicos presentan fallas metodológicas. Sin embargo, ciertos enfoques parecen ser prometedores entre los adultos. Por ejemplo, en lo que respecta al mantenimiento de la abstinencia del juego, se destacan el método cognitivo-conductista y los grupos de apoyo del tipo Gamblers Anonymes (GA). Otros trabajos recientes presentan resultados alentadores obtenidos con la aplicación del enfoque farmacológico. La administración de Naltrexone a los jugadores patológicos permitiría disminuir el deseo obsesivo de jugar. Se comienza de esta manera a reconocer que el modelo transteórico del cambio y el método de terapia conyugal contribuyen por cierto a mejorar la retención de los jugadores adultos en tratamiento. La oferta de tratamiento está menos desarrollada en el caso de los adolescentes. Las iniciativas de programas de intervención para los jóvenes que presentan un problema de juego son todavía embrionarias y adoptan en general los paradigmas del enfoque cognitivo-conductista. Será necesario también reflexionar sobre los criterios escogidos correspondientes con el éxito de un tratamiento, ya sea para los adultos o para los adolescentes. La abstinencia completa de todos los juegos de azar y de dinero es quizás el único indicador de restablecimiento

Psychological distress increases needle sharing among cocaine users: Results from the COSMO study

Objective: Cocaine use and mental health disorders have both been separately identified as risk factors for blood borne virus infection. However, the contribution of specific underlying aspects of mental health to risks is not well documented. The aim of this study was to examine the association between psychological distress and risk behaviors for HIV and Hepatitis C infection among cocaine users. Methods: Individuals who either smoked or injected cocaine were recruited in community-based and addiction treatment programs located in downtown Montreal. Participants were asked to complete an interviewer-administered questionnaire assessing psychological distress based on the Kessler scale (K10). Three-month risk behaviors outcomes included drug injection material sharing (needle, dilution water, cooker, filters, backloading, frontloading or wash), and smoking equipment sharing. Socio-demographic data, severity of cocaine dependence and other substances use information were also collected. Statistical analyses were conducted using logistic regression. Results: Severe psychological distress was reported by 202 (34.3%) out of 589 participants (86.2% male; 76.6% ≥ 30y.o.). The prevalence of sharing was: 14.8% for needles, 24.9% for other injection equipment (378 injectors) and 68.3% for smoking material (508 smokers). Multivariate analysis showed that injectors with severe psychological distress were more likely to report needle sharing (Adjusted Odds Ratio (AOR): 2.1, 95% CI: 1.1-3.8). No significant association was found between K10 score and sharing of other paraphernalia. Conclusion: Severe psychological distress increases the risk of needle sharing, a major risk factor for HIV and HCV infection, but not sharing of other paraphernalia. These results suggest differential psychological mechanisms according to sharing practices. They also support the importance of screening for psychological distress in order to implement adequate preventive interventions aimed at cocaine users

Anxiety, mood disorders and injection risk behaviors among cocaine users : results from the COSMO study

Abstract : BACKGROUND AND OBJECTIVES: Despite being common among cocaine users, mental health problems and their relationship with HIV and hepatitis C high risk injection behaviors are poorly documented. This study was undertaken to examine the relationships between mood and anxiety disorders and the sharing of drug injection equipment among cocaine users who inject drugs. METHODS: The sample was drawn from a prospective cohort study and comprised of 387 participants. The outcome of interest was "sharing injection material" in the past 3 months. The presence of mood and anxiety disorders during the past year was assessed using the CIDI questionnaire. Statistical analyses were conducted on baseline data using logistic regression. RESULTS: Most participants were male (84.5%) and were aged 25 or over (92.2%); 43.0% qualified for an anxiety disorder diagnosis and 29.3% for a mood disorder diagnosis. Participants with anxiety disorders were more likely to share needles (Adjusted Odds Ratio [AOR]: 2.13, 95%CI: 1.15-3.96) and other injection material (AOR: 1.81, 95%CI: 1.12-2.92). No significant association was found between mood disorders and sharing behaviors. DISCUSSION AND CONCLUSIONS: Primary anxiety disorders but not mood disorders increases injection risk behaviors among cocaine users. These results bring to light another negative outcome of mental health comorbidity in this vulnerable population. SCIENTIFIC SIGNIFICANCE: This study underlines the need to fine-tune therapeutic approaches targeting specific mental health problems in individuals with cocaine use disorders. Longitudinal studies that assess impulsivity and other correlates of psychiatric disorders are needed to examine underlying mechanisms of high risk injection behaviors in comorbid populations