E-Book, Englisch, 123 Seiten
Whelan / Meyers / Steenbergh Problem and Pathological Gambling
1. Auflage 2007
ISBN: 978-1-61334-312-8
Verlag: Hogrefe Publishing
Format: EPUB
Kopierschutz: 6 - ePub Watermark
E-Book, Englisch, 123 Seiten
Reihe: Advances in Psychotherapy - Evidence-Based Practice
ISBN: 978-1-61334-312-8
Verlag: Hogrefe Publishing
Format: EPUB
Kopierschutz: 6 - ePub Watermark
An easy-to-use guide leading clinicians through a cost-efficient approach to one of today’s major addictions: problem or pathological gambling. Over the past 30 years there has been a dramatic increase in the availability of convenient and legal gambling opportunities. Most people can reach a casino in a matter of a few hours, lottery tickets in minutes, or an online gaming site in seconds. Accompanying this proliferation of gambling is a growing understanding that between 5% and 9% of adults experience significant to severe problems due to their gambling activities. These problems have become a real health concern, with substantial costs to individuals, families, and communities.
The objective of this book is to provide the clinician – or graduate student – with essential information about problem and pathological gambling. After placing this behavioral addiction and its co-occurring difficulties in perspective, by describing its proliferation, the associated costs, and diagnostic criteria and definitions, the authors present detailed information on a strategy to assess and treat gambling problems in an outpatient setting.
They go on to provide clear and easy-to-follow intervention guidelines, including homework assignments, for a brief and cost-efficient cognitive behavioral approach to problem gambling, involving stepped care and guided self-change. Means of countering problems and barriers to change and vivid case vignettes round off this thorough, but compact guide for clinicians.
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Weitere Infos & Material
1 Description of Problem and Pathological Gambling 1.1 Terminology Gambling defined Gambling can be defined as any behavior involving the risk of money or valuable possessions on the outcome of a game, contest, or other event in which the outcome is at least partially determined by chance. There are many forms of gambling: purchasing lottery tickets, participating in sports pools, an evening at the casino, wagers on the golf course, or speculating on the futures and stock markets. Sometimes we actually call it gambling; other times we use terms that are less pejorative, such as gaming, investing, or a friendly wager. A variety of terminology has been used to describe the degree to which individuals experience gambling-related problems. Some of these terms, such as compulsive gambling, reflect dated conceptualizations of the problem while others were adopted as early screening instruments were developed. Understanding this language can be difficult, particularly because many of the terms have been used inconsistently. We will return to this issue in Section 1.1.2. 1.1.1 Gambling as Recreation Gambling is available and acceptable The study by Welte and colleagues (2002) has provided a great deal of information about the gambling behavior of those living in the U.S. As shown in Table 1, individuals who have gambled in the past year wagered an average of $1,735 over 60 episodes during that year. While similar percentages of women and men gambled, interesting differences between the two emerge. Compared to women, men were more likely to gamble weekly, wager more frequently, and with more money. A smaller percentage of ethno-cultural minorities, compared to Caucasians, gambled, but if they did gamble they tended to gamble more often and spend more money. The percentage of respondents who gambled in the past year decreased with increasing age. However, the amount of money wagered per year did not change as age increased. Gamblers wagered with similar frequency and intensity regardless of age. Purchasing lottery tickets (66%) was by far the most common form of gambling followed by raffles, charitable gambling, or office pools (48%). However the level of financial investment in these activities was considerably lower than for other forms of gambling. Twenty-seven percent of respondents reported casino gambling. Casino gamblers, racetrack bettors, and dice game players tended to expend larger amounts of money compared to those who engaged in other gambling activities. Interestingly, internet gambling was reported by less than one percent of the sample, although most believe that internet gambling is a growing market, and possibly a growing problem. Table 1
Past Year Gambling as Reported in the National Survey on Gambling Behavior, 1999–2000 (N = 2630) % Gambled % Gambled weekly Mean gambling episodes Mean gambling involvement in U.S.$/yr. All 82 23 60 $1,735 Sex Female 80 17 46 $1,097 Male 84 29 74 $2,390 Ethnicity Caucasian 83 23 54 $1,295 African-American 75 26 97 $3,763 Hispanic 83 22 65 $2,223 Asian-American 82 16 37 $1,379 Age 18–30 yrs 89 19 53 $1,689 31–40 yrs 86 25 63 $1,729 41–50 yrs 83 28 60 $2,052 51–60 yrs 81 28 66 $1,559 61+ yrs 69 21 63 $1,582 Adapted from Welte, J. W., Barnes, G. M., Weiczorek, W. F., Tidwell, M. C., & Parker, J. (2002). Gambling participation in the U.S.: Results from a national survey. Journal of Gambling Studies, 18, 313–338. For those living on the U.S. mainland, casinos are within a few hours drive of their home or work, lottery tickets are a corner store away, and internet gambling can be readily accessed on the home or office computer. This provides easy access to a leisure activity that continues to enjoy growing acceptance. 1.1.2 Continuum of Gambling-Related Harm Gambling problems have been around as long as gambling itself and many professionals have explored the psychology behind this problematic behavior. Accompanying the recent proliferation of legalized gambling has been an increasing push to refine how gambling-related problems are conceptualized. The view that has dominated the treatment and research literature in recent years is that gambling-related harm exists on a continuum from no gambling to severe problems or pathological gambling (National Research Council, 1999; Shaffer, Hall, & Vander Bilt, 1997). Table 2
Continuum of Gambling-Related Harm Category Description Adult lifetime prevalence (95% confidence interval) Adult past year prevalence (95% confidence interval) Level 1 Recreational gambler or nongambler If gambles, it is for social reasons and rarely exceeds self-imposed limits 94.7% (93.7 to 95.6) 96.1% (95 to 97) Level 2 Problem gambler Some diagnostic symptoms or gambling-related distress; subclinical 3.8% (2.9 to 4.8) 2.8% (2.0 to 4.8) Level 3 Pathological gambler Meets at least 5 diagnostic criteria 1.7% (1.4 to 1.9) 1.1% (0.9 to 1.4) Adapted from Shaffer, H. J., Hall, M. N., & Vander Bilt, J. (1997). Estimating the prevalence of disordered gambling behavior in the United States and Canada: A meta-analysis. Harvard Medical School Division of Addiction. This continuum was initially proposed as an attempt to organize the confusing and chaotic set of labels used to describe those who have been harmed by their gambling. Some of the terms that have appeared in the clinical and research literature include compulsive gambling, at-risk gambling, in-transition gambling, potentially pathological gambling, and probable pathological gambling. In an effort to organize these concepts in order to estimate the prevalence of gambling problems, Shaffer and colleagues proposed a continuum of gambling harm (see Table 2). At one end of the continuum are those who gamble for social or recreational reasons. They use their discretionary money to gamble and are reluctant to exceed their self-imposed monetary limits. These individuals, sometimes referred to as recreational gamblers or Level 1 gamblers, typically wager with little or no financial, psychological, or interpersonal harm. Shaffer and colleagues (1997) described those in the middle of the continuum as having subclinical levels of gambling problems and defined them as Level 2 gamblers. They present some gambling-related symptoms or problems, but do not meet diagnostic criteria. Level 2 gambling is an ambiguous concept. It includes people who have reported one gambling-related problem or gambling-related symptom during the past year as well as those who might have historically had gambling concerns but currently do not meet diagnostic criteria. These individuals may be in transition toward either end of the continuum, but they might also continue to experience a modest level of gambling-related problems or symptoms for years. Their clinical manifestations, therefore, vary widely. Level 2 gamblers have been considered analogous to individuals diagnosed with substance abuse disorder. At the far end of the continuum are those who meet criteria for pathological gambling disorder. Referred to by Shaffer and colleagues as Level 3 gamblers, they present with severe and persistent gambling-related symptoms. Their problems are seen as chronic, debilitating, and include significant impairment in daily...
