The WAGER, Vol. 14(5) - What’s in a game? Are certain types of gambling more likely to lead to disordered gambling?

At present, research findings are mixed about the impact of specific forms of gambling on gambling-related problems. Using limited samples, some studies have found an association between specific gambling activity and disordered gambling (e.g., Wood & Griffiths, 1998), often implicating gambling machines as especially “addictive” because of their high rate of gambling opportunities. Treatment seekers often report disproportionate rates of play on specific games. However, treatment seekers are not representative of others with similar problems. Therefore, it is not surprising that some researchers (e.g., National Research Council, 1999; Welte, Barnes, Wieczorek, Tidwell, & Parker, 2004) have found that the number of gambling activities is more predictive of problem gambling.  This week’s WAGER reviews a study that examines the relationship between specific forms of gambling and gambling-related problems among a nationally representative sample of U.S. youths (Welte, Barnes, Tidwell, & Hoffman, 2009).

Methods

• Participants were U.S. youths (ages 14-21) selected via random digit dialing of household telephone numbers who completed the National Survey of Youth and Gambling (N = 2,274).
• Interviews assessed past year gambling behavior and gambling-related problems.
  •  Investigators used a researcher-developed survey to assess participant involvement in 15 gambling activities or settings.
  • Investigators evaluated gambling-related problems using the South Oaks Gambling Screen Revised for Adolescents (SOGS-RA).

Results

• Sixty-eight percent of study participants (N=1,535) reported gambling during the previous twelve months; the highest percentage of these gamblers reported engaging in card games (33%), office pools and charitable gambling  (30%), and the lottery (29%).
• Table 1 summarizes the risks for gambling-related problems and gambling versatility (i.e., mean number of types of gambling in which respondents engaged) for each gambling activity/setting.
  • Overall, higher levels of gambling versatility were associated with more gambling-related problems.
• Researchers performed incidence risk ratio analyses to investigate the impacts of engaging in particular forms of gambling while controlling for all other types of gambling behavior.
  • After controlling for involvement in other games/settings, card games, games of skill, gambling at casinos, and ‘other’ gambling were associated with an increased risk of gambling-related problems.  
  • Other gambling types, including Internet gambling, were not associated with increased risk when controlling for involvement in other gambling activities.

Table 1.  Prevalence of Any Gambling Symptoms and Gambling Versatility on All Forms of Gambling for Gamblers Who Played Each Form of Gambling, U.S. Youth and Gambling Survey (Adapted from Welte et al., 2009)

  

Limitations

• Self-report of gambling activity involvement and potential problem gambling behavior can be associated with recall and reporting bias.
• Data was collected using random digit dialing of household phones, which only occasionally included cell phones.  This strategy generally limits the study sample to youths with a landline home telephone. This group might not be representative of the youth population segment.
• Study questions did not distinguish gambling settings from specific forms of gambling (e.g., questions were asked about casino gambling and about gambling machines not in a casino but not about gambling machines in casinos).

Conclusion
The findings from this study do not support the idea that the most rapid forms of gambling, such as gambling machines, are the most problematic type of game. The finding that gamblers who had higher gambling versatility (i.e., experience with more types of gambling) were more likely to experience gambling problems is, however, consistent with previous research (e.g., National Research Council, 1999; Welte et al., 2004) showing that overall gambling involvement is a more useful predictor of gambling-related problems than participation in specific gambling types.  A high correlation between a specific type of gambling (e.g., Internet gambling) and problem gambling does not reflect a causal influence; this association might mean that devotees of that type of gambling also engage in a lot of other gambling. Youth gambling prevention and harm reduction programs might benefit by incorporating the findings of this study into their practices.  Specifically, by focusing less on particular types of gambling and focusing more on the potential risks of high levels of gambling engagement, such programs might better prevent or reduce the harms associated with youth problem gambling behavior.

-Erica Marshall

What do you think?  Please use the comment link below to provide feedback on this article.

References
National Research Council. (1999). Pathological gambling: A critical review. Washington D.C.: National Academy Press.

Welte, J., Barnes, G., Tidwell, M., & Hoffman, J. (2009). The association of form of gambling with problem gambling among American youth. Psychology of Addictive Behaviors, 23(1), 105-112.

Welte, J., Barnes, G., Wieczorek, W., Tidwell, M., & Parker, J. (2004). Risk factors for pathological gambling. Addictive Behaviors, 29(2), 323-335.

Wood, R. T., & Griffiths, M. D. (1998). The acquisition, development and maintenance of lottery and scratchcard gambling in adolescence. Journal of Adolescence, 21(3), 265-273.

 

Comments

[RH]

This is a very misleading title. The researchers only looked at the players' behaviors, not "what's in the games". Of course if you only look at the players and not the games, such as specific game characteristics that may increase risks, you'll conclude it's all about the players, not the games. This is common sense that the researchers seem to lack. These conclusions are ethically irresponsible in the absence of looking at game specific characteristics that potentially increase risk. Advising that prevention should not focus on specific games that obviously have their own specific risk factors, is also ethically irresponsible and minimizes potentially hazardous game characteristics that research and prevention should be focused. Seems like the researchers hold an undeclared bias that all games and gambling are benign, which is blinding them from looking at the obvious. The gaming experience affects behaviors.

R.H.

[The BASIS Staff]

Dear R.H.,

Thank you for writing to the BASIS and for your interest in the WAGER 14(5), What’s in a game? Are certain types of gambling more likely to lead to disordered gambling? You have raised several concerns about our review of the Welte, Barnes, Tidwell & Hoffman article ( 2009); these include concerns about the methods Welte et al. employed and the potential bias associated with the original article and how we reported it in the WAGER. Charges of ethical irresponsibility are significant and we take such an indictment very seriously. Consequently, in this response, we will address each of these matters.

Your first concern is with the title of this WAGER. BASIS titles are intended to both catch the eye of the reader and identify the research aims of the study under review. We are sorry to learn that you thought this particular title missed its mark. You also raise concerns about our suggestion that adolescent gambling prevention programs shift their focus to overall gambling versatility and focus less exclusively on specific types of gambling. We based our suggestion to shift the focus of prevention programs because the findings of this particular study support this assertion. However, this WAGER did not suggest abandoning game-specific interventions; we simply suggested that prevention and harm reduction programs might benefit adolescents by expanding their scope to include this research-identified correlate of problem gambling behavior.

Your overarching concern with the study methodology was that the authors’ did not include an assessment of the characteristics of specific gambling activities. You contend that such characteristics might make participants of certain gambling activities more susceptible to gambling problems than participants of other gambling activities. In the absence of evidence, your position has been widely shared. Contrary to your claim, Welte et al. did examine one such game characteristic (e.g., speed of play) and found that it did not influence gambling patterns. The aim of Welte et al.’s study was not to assess such characteristics in general; rather, this research group assessed a specific game feature. They also examined the extent of gambling involvement to evaluate whether participation in particular gambling activities were associated with problem gambling behavior. Although we support more research to examine other characteristics of games and to determine whether these are associated with gambling-related problems, there is some evidence available that bears on this matter.

Your correspondence suggests that certain gambling activities are more dangerous than others. This is a legitimate hypothesis. However, the current and an emerging body of new research fail to provide support for this position. For instance, popular convention holds that electronic gambling machines are “more addictive” than other gambling activities; yet, a comprehensive review (Dowling, Smith, & Thomas, 2005) of the existing evidence concerning gambling behavior and electronic gambling machines casts doubt on this presumption by showing this claim is not supported by empirical evidence. The Welte et al. study adds to this body of evidence. We also have new research that provides support for the Welte et al. finding. In the face of this growing body of evidence, it would be biased and irresponsible to suggest that certain gambling activities are more dangerous than others.

In contrast to your contention that characteristics of games lead to gambling problems, recent empirical research indicates that overall gambling involvement and the diversity of games played might be more predictive of problem gambling behavior than engagement in specific gambling types. As we noted in the WAGER, researchers have found a connection between the number of gambling activities engaged in and problem gambling behavior (e.g., National Research Council, 1999; Welte, Barnes, Wieczorek, Tidwell, & Parker, 2004). Regardless of game features and player characteristics, it is important to note that the development of problem gambling behavior is neither exclusively the result of gambler behavior nor the characteristics of gambling activities. Rather, interactions between players and games are essential. Games do not cause problem gambling; they provide the theater of opportunity for gambling problems to emerge. You have raised a valid criticism of the field by noting that we need more research to clarify this matter further.

Finally, you charge that Dr. Welte and his colleagues, as well as the BASIS staff, operate with “an undeclared bias that all games and gambling are benign.” Although this study found that gambling involvement and diversity were predictive of gambling problems, neither Welte et al. nor us have suggested that either games or gambling is benign. Indeed, gambling is a risk taking activity. In fact, Welte et al. did mention that card games, games of skill, gambling at casinos, and ‘other’ gambling were associated with an increased risk of gambling-related problems. This statement directly disputes your charge that the authors consider all gambling activities as “benign.”

Rigorous, scientifically sound research should reach objective conclusions based on the available evidence regardless of any personal feelings held by the investigator(s) about the subject under investigation. To meaningfully advance a scientific understanding, research must operate free of personal or political agenda and be willing to accept findings that differ from conventional wisdom or popular thought. That is, we must be willing to revise our positions when the evidence supports such a change. Dr. Welte and his colleagues conducted a methodologically sound, empirical study; we find no evidence of bias in their work. Further, the BASIS staff strives to report the current research as objectively as possible. Our goal is to report studies that advance our understanding of addiction by providing scientific evidence, regardless of whether these findings are consistent with currently held assumptions – either our own or the field at-large.

For more, please see Dr. Welte’s recent editorial for the BASIS where he describes his work in this area.

Again, thank you for your interest in the BASIS and for your comments. We always appreciate feedback, questions, and comments from readers.

--The BASIS Staff

References

Dowling, N., Smith, D., & Thomas, T. (2005). Electronic gaming machines: are they the 'crack-cocaine' of gambling? Addiction, 100(1), 33-45.

National Research Council. (1999). Pathological gambling: A critical review. Washington D.C.: National Academy Press.

Welte, J. W., Barnes, G. M., Tidwell, M. C., & Hoffman, J. H. (2009). The association of form of gambling with problem gambling among American youth. Psychology of Addictive Behaviors, 23(1), 105-112.

Welte, J. W., Barnes, G. M., Wieczorek, W. F., Tidwell, M. C., & Parker, J. C. (2004). Risk factors for pathological gambling. Addictive Behaviors, 29(2), 323-335.