Ferris et al. found that “ . . . 80% of Ontarians have no problems with gambling, 17% have between one and two problems, about 2% have between three and four problems and may be considered “problem” or “potential pathological” gamblers, and 2% meet the criteria for likely pathological gambling” (Ferris et al., 1996, p. 20). These figures represent the upper end of Ontario prevalence estimates. The lower end of the estimates for Ontario are those for the city of Windsor, Ontario with 1.1% +– 0.3% for people affected by problem gambling and 1.1% +– 0.3% for pathological gamblers (Govoni & Frisch, 1996, p. 6). Both prevalence figures fit within the range described in the DSM-IV description of pathological gambling — 1% to 3% (American Psychiatric Association, 1994, p. 617)
Age
The age groups 18-29 and 40-49 were more likely to report gambling problems, with 30 to 39-year-olds less involved, and those 50 and up in age reporting the fewest gambling problems (Ferris et al., 1996, p. 21). Among youth aged 14 to 19 years old in Windsor, Ontario, Govoni found 8.1% +–1.8% evidenced problem gambling based on a version of the SOGS designed for adolescents (Govoni, Rupcich & Frisch, 1996).
Gender
Males were overwhelmingly represented among the problem gamblers, being 72% of those with three to four problems or likely people affected by problem gambling, and 79% of those with five or more problems as likely pathological gamblers (Ferris et al., 1996, p. 20). In the Donwood program, males represented 89% of clients (Donwood Institute, 1996, p. 25). Interestingly though, in a Windsor, Ontario study among substance users in treatment, men and women had similar rates with both “probable pathological gambling” (17% and 13%, respectively) and as “problem gamblers” (12% and 11%, respectively) (Rupcich, Frisch & Govoni, 1997).With youth, Govoni et al. found among grade 10 to grade 13 students in Windsor, Ontario that rates of problem gambling were 11.8% for males and 4.8% for females (Govoni et al., 1996, p. 314).
Marital status
People with gambling problems were most likely to report being single, i.e., either never married or divorced/separated (Ferris et al., 1996, p. 23).
Educational level
In their population survey, level of educational attainment showed no relationship with problem gambling (Ferris et al., 1996, p. 22).
Family income
Level of gambling problems and family income were not significantly related (Ferris et al., 1996, p. 23).
Social class — a summing up
If educational level and family income roughly approximate what social scientists call social class, then Ferris’s 1996 data show no evidence for social class differences in prevalence or severity of gambling problems.
Ethnicity
One approach to ethnicity is to consider language spoken in the home and by this variable Ferris et al. (1996) found no relationship with problem gambling or levels of severity (p. 25).
Preferred forms of gambling
People affected by problem gambling often play a variety of games. Nonetheless, many see one or more games as their principal problem. Rupcich found, with 207 gamblers in treatment, that for 64% casino gambling was their principal problem, and for 43% lotteries were their main problem (Downey, 1995).
Level of debt and amount lost gambling
Nick Rupcich was quoted in a Globe and Mail article as stating that 207 gamblers in treatment had an average debt of $16,000 on an average income of $31,000 (Downey, 1995).
Alcohol use
“...[H]eavy drinking and drinking problems are associated with higher levels of spending on gambling and reports of gambling problems” (Smart & Ferris, 1996, p. 36).
Drug use
Smart’s 1994 population survey found no real relationship between drug use and gambling problems (Smart & Ferris, 1996, pp. 39, 44).
Substance use
However, a complementary approach is to approach substance users (i.e., drugs and/or alcohol) who are in treatment and administer the SOGS to assess how many might also have serious gambling involvement. Rupcich (Rupcich et al., 1997) found among clients at a Windsor, Ontario substance treatment facility that 14.3% were “probable pathological” gamblers and another 11% scored in the “problem gambler” range. From such findings, Smart & Ferris (1996) and Rupcich (1997) recommend a gambling assessment component, the SOGS for example, for all who enter substance use treatment programs.
Psychiatric Comorbidity — Two Contrasting Approaches
A common research project involves assessing a sample of people affected by problem gambling for their mental health problems. A recent example of this is Black and Moyer’s (1998) study in Iowa of 30 subjects diagnosed as pathological gamblers. They found that 40% had a lifetime anxiety disorder, 60% had a lifetime mood disorder, and 87% had a personality disorder, “... the most common being obsessive-compulsive, avoidant, schizotypal, and paranoid personality disorders” (Black & Moyer, 1998, p. 1434).
A very different approach is to critically review the research literature on gambling and psychiatric comorbidity, as did Crockford and el-Guebaly (1998) by examining 60 recent publications. From this work, they conclude that “methodological concerns and inconsistencies in the data make some of these high [psychiatric] comorbidities questionable” (Crockford & el- Guebaly, 1998, p. 43). For example, they suggest that the high prevalence of mood disorders frequently reported may result from sampling biases, and not from comorbidity (Crockford & el-Guebaly, 1998, p. 46). Some common methodological problems were small sample sizes, possible sampling biases, use of different diagnostic instruments, lack of appropriate control groups, inconsistent demographic data (even for such basic information as ethnic background and age), no information on degree of gambling problem, and lack of information on whether the comorbidity preceded or followed problematic gambling, and reliance on retrospective self-reports of childhood behaviour for some diagnoses (Crockford & el-Guebaly, 1998).
Psychiatric comorbidity/impulsivity
Increased impulsivity was associated with more severe gambling and behavioural problems in two samples of pathological gamblers (Blaszczynski, Steel & McConaghy, 1997; Steel & Blaszczynski, 1998). Furthermore, the concept of impulsivity is central to pathological gambling’s current classification as a DSM-IV 312.31 “disorder of impulse control” (American Psychiatric Association, 1994, pp. 615-618).
Psychiatric comorbidity/anxiety disorders
Crockford and el-Guebaly surveyed this literature and concluded that there are insufficient data to link anxiety disorders and pathological gambling (Crockford & el-Guebaly, 1998, p. 47).
Psychiatric comorbidity/antisocial personality disorders
A “small but significant subset” of pathological gamblers may have antisocial personality disorder, but the rest of the minority of pathological gamblers who may show such symptoms do so as a result of their gambling activities, not as part of psychiatric comorbidity (Crockford & el-Guebaly, 1998, pp. 47-48).
Psychiatric comorbidity/attention deficit hyperactivity disorder (ADHD)
Some researchers have attempted to link pathological gambling and ADHD, but the few results and methodological shortcomings do not convince Crockford and el-Guebaly that this syndrome is commonly comorbid with pathological gambling (Crockford & el-Guebaly, 1998, p. 48).
Smart’s population survey in Ontario provides some insights into how people affected by problem gambling live. One insight is the strong link between alcohol dependence and gambling problems, showing a pattern of not much more total consumption than average, but rather occasions on which gamblers consumed five or more drinks — a tendency to sporadic heavy drinking (p. 39). Smart also (p. 44) briefly summarizes the literature on women’s and men’s different problem gambling careers. Women tend to have shorter problem gambling careers, usually beginning to gamble in later adolescence or even adulthood, but seeking treatment earlier, in their 30's and 40's. Men tend to start gambling in their early teens, but take a long time, until they are in their 40's or 50's, to develop serious enough problems that they seek treatment. An interesting parallel between alcohol and gambling problems is that although heavier use occurs among the young, those who seek treatment tend to be middle-aged (Smart, 1996, p. 43).
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