Session 1-4-A: Comparing Longitudinal Studies of Gambling: Methods & Findin

What do we know about risk factors for PG? Vast majority of research carried out on PG risk factors has involved cross-sectional surveys PG status at a single point in time statistically correlated with behaviors & characteristics assessed at the same time Cannot resolve the “chicken and egg” problem Does PG precede other disorders? Do other disorders precede PG? Or does one underlying condition account for both

Monitoring Gambling Impacts in Massachusetts: Honing Strategies and Preventing Harm

In November 2011, an Act Establishing Expanded Gaming in the Commonwealth of Massachusetts was signed into law (Chapter 194 of the Acts of 2011). This legislation permits casinos and slot parlors in Massachusetts under the regulatory auspices of the Massachusetts Gaming Commission (MGC). Section 71 of the Expanded Gaming Act requires the MGC to establish an annual research agenda to assist in understanding the effects of casino gambling in Massachusetts and in minimizing the negative impacts. Research activities launched thus far include a comprehensive study of the social and economic impacts of casino gambling in Massachusetts (SEIGMA), a cohort study of the incidence and etiology of problem gambling (MAGIC), a strategic plan for the expansion of problem gambling services in Massachusetts, a community-level analysis of policing activities in communities surrounding the casinos, and an evaluation of responsible gambling activities (i.e., exclusion program, play management system, responsible gambling information centers). The presentation will include a selection of results from the large baseline population survey completed in 2014, prior to the opening of any casinos or slot parlors as well as highlights from our baseline economic and fiscal impact analysis. By highlighting a successful multi-sector collaboration, the presentation will underscore the importance of collaboration between academic researchers, economic and policy analysts, regulators, and community stakeholders in both assessing and addressing gambling impacts

Comorbid pathological gambling, mental health, and substance use disorders: Health-care services provision by clinician specialty

Background and aims Pathological gambling (PG) is an impulse control disorder. This study assessed the burden of co-occurring behavioral addictions and mental health disorders in treatment-seeking patients and estimated the likelihood of receiving care for these disorders by clinician specialty. Methods Study data were derived from the Massachusetts All-Payer Claims Database, a representative database, for the period 2009–2013. The sample included commercially insured adult residents of Massachusetts. Univariate and multivariate logistic regressions were used to estimate the likelihood of provision of care by clinician specialty adjusting for patient’s demographic characteristics and level of care. Bonferroni correction was applied to adjust for multiple testing. Results The study sample included 869 patients. Treatment-seeking patients who had a diagnosis of PG were mostly males (71%), aged 45–54 years (26.7%) and enrolled in a health maintenance organization (47%). The most prevalent co-occurring disorders among patients with PG as principal diagnosis were anxiety disorders (28%), mood disorders (26%), and substance use disorders (18%). PG was associated with a more than twofold likelihood of receiving care from social workers and psychologists (p  Discussion and conclusions Psychiatric and substance use disorders are prevalent among treatment-seeking pathological gamblers. The likelihood of receiving care from specialty clinicians significantly varies by clinical diagnosis and patient clinical complexity

The association of at-risk, problem, and pathological gambling with substance use, depression, and arrest history

We examined at-risk, problem, or pathological gambling co-occurrence with frequency of past-year alcohol, tobacco, and marijuana use; depressive symptoms; and arrest history. Data included the responses of over 3,000 individuals who participated in a 2006 telephone survey designed to understand the extent of at-risk, problem, and pathological gambling; comorbidity levels with substance use; mental health; and social problems among Southwestern U.S. residents. Data were analyzed with multinomial and bivariate logistic regression. Respondents at risk for problem gambling were more likely to use alcohol, tobacco, and marijuana than those respondents not at risk. Pathological gamblers were no more or less likely to consume alcohol or tobacco than were non-gamblers or those not at risk. A dose-response relationship existed between degree of gambling problems and depressive symptoms and arrest history. Interventions for at-risk or problem gamblers need to include substance use treatment, and the phenomenon of low levels of substance use among pathological gamblers needs further exploration

Etiology and Stability of Problem Gambling

Prevention of problem gambling hinges on having research that clearly identifies the variables that are etiologically involved, their temporal sequence, and their causal connections. Longitudinal research is the best way of disentangling the chronology and causal relationships between variables. The present research describes the results of the two major longitudinal studies of gambling in Canada: the Quinte Longitudinal Study (QLS) (n = 4,121) and the Leisure, Lifestyle, Lifecycle Project (LLLP) (n = 1,808). The first part of the presentation describes the stability of gambling classifications over a 5 year period. This is followed by an identification of the univariate and multivariate predictors of future problem gambling and the implications these results have for prevention. The final part of the presentation describes the purpose and methodology of a new longitudinal study in Massachusetts: the Massachusetts Gambling Impact Cohort (MAGIC (n = 3,141)

Developing a short form of the PGSI : report to the Gambling Commission

The aim of the present project is to provide the Gambling Commission and its stakeholders with advice on the feasibility and suitability of a new brief three‐item PGSI Short‐Form derived from the longer Problem Gambling Severity Index (PGSI) for use in tracking the prevalence of problem gambling in the general population. The present report begins with a summary of the latest developments in the area of problem gambling screening. This is followed by a brief discussion of the problem gambling construct and then a longer consideration of how the performance of different assessment instruments is affected by survey methodology. The next three sections evaluate the performance of the new PGSI Short‐Form in the (a) 2009 and 2010 British omnibus surveys, (b) the 2007 and 2010 British Gambling Prevalence Surveys, and (c) in a large sample of English‐speaking clinically assessed gamblers. The final section of the report provides a summary of our findings and recommendations for the future.Gambling CommissionYe

Developing a brief problem gambling screen using clinically validated samples of at-risk, problem and pathological gamblers

Report to the Alberta Gaming Research InstituteScreening for problem gambling takes place in both clinical settings and in population research. Several short assessment tools for problem gambling have been developed over the past decade for use in these settings. However, the performance of all of these brief screens has been assessed in relation to the longer screens from which they are derived. The purpose of the present study is to identify a subset of items taken from all of the most widely-used problem gambling screens that is effective in capturing the large majority of clinically-assessed at-risk, problem and pathological gamblers. A secondary goal is to examine the performance of existing short screens in correctly identifying clinically assessed individuals. The present study uses data collected in two surveys that included all of the most widely used problem gambling screens and classified respondents based on clinical assessments. The sample includes over 7,000 North American gamblers. The 30 unique problem gambling items were sorted into three dimensions (gambling motivations, behaviors and consequences) and the items most closely correlated with the clinically-assessed At-Risk, Problem and Pathological Gamblers in the two surveys and capturing 50% or more of the Pathological Gamblers and 5% or less of the Recreational Gamblers were identified. Once the candidate items in the two surveys were identified, the performance of all two-item, three-item, four-item and five-item combinations was examined to assess capture rates in each sample. All combinations that captured 98% of the Pathological Gamblers, 94% of the Problem Gamblers and 80% of the At-Risk Gamblers were considered eligible for further investigation. This consisted of determining the classification accuracy of the most promising combinations of items. Each of the promising combinations was then further examined for its performance across gender, age and ethnicity to assess the level of measurement invariance associated with each combination. Based on performance across both surveys and measurement invariance across major demographic groups, a combination of five items including one motivation item, three behavior items, and one consequences item was identified as the best brief screen for clinically-assessed at-risk, problem and pathological gambling. In contrast, the performance of item combinations that best represented other brief problem gambling screens developed in recent years was unsatisfactory. This underscores the importance of assessing the performance of brief screens in relation to clinical assessments rather than in relation to the longer screens from which they are derived.Gemini ResearchN

Gambling and problem gambling in Ontario

A random sample of 4,035 Ontario adults (18+) was administered a telephone survey regarding their gambling attitudes, motivations for gambling, gambling behaviour, and problem gambling status. The survey was conducted between November 2010 and April 2011.Ye

Impact of Survey Description, Administration Format, and Exclusionary Criteria on Population Prevalence Rates of Problem Gambling

Sherpa Romeo green journal. Permission to archive accepted author manuscript.The present study investigated the impact of survey administration format, survey description, and gambling behaviour thresholds on obtained population prevalence rates of problem gambling. A total of 3,028 adults were surveyed about their gambling behaviour, with half of these surveys administered face-to-face and half over the phone, and half of the surveys being described as a 'gambling survey' and half as a 'health and recreation' survey. Population prevalence rates of problem gambling using the CPGI were 133% higher in 'gambling' versus 'health and recreation' surveys and 55% higher in face-to-face administration compared to telephone administration. If people with less than $300 in annual gambling expenditures are not asked questions about problem gambling, then the obtained problem gambling prevalence rate is 42% lower. When all of these elements are aligned they result in markedly different problem gambling prevalence rates (4.1% versus 0.8%). The mechanisms for these effects and recommended procedures for future prevalence studies are discussed.Ontario Problem Gambling Research CentreYe