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Two recent meta-analyses of gambling-disorder prevalence rates1,2 reported that problem gambling behavior in Canada and the United States is consistently higher in adolescents than in adults. In spite of these results, gambling-disorder treatment specialists find that adolescents rarely seek treatment for the problem. In surveys of gambling-disorder treatment populations in six states, Volberg3 found a predominantly middle-aged population in gambling disorder treatment. If adolescents with gambling disorders outnumber adults, why are so few adolescents in gambling treatment?
Some plausible explanations for this phenomenon include lack of public awareness about adolescent gambling problems and the availability of adolescent gambling treatment. Furthermore, the time required for problem gambling to reach clinical proportions and thus trigger treatment seeking could be a partial cause. Lack of acceptable treatment or accessibility barriers for adolescents may also decrease treatment seeking in this population. Typically, treatment for adolescents may focus on comorbid addiction behaviors such as alcohol, marijuana, or other illicit substance abuse that masks gambling issues.
A key factor in adolescent gambling behavior may be perception of risks involved with gambling. If adolescents are not deterred from alcohol, tobacco and drug use despite warnings of potentially harmful physiological effects, then they might perceive gambling as even less risky because it inflicts no apparent physical harm. If participation is influenced by perception of risk, and gambling risk is perceived as lower than other addictive behaviors, then adolescents might show even greater participation rates in gambling than in substance use.
Since gambling was recently legalized in Louisiana, the present generation of adolescents in Louisiana is the first to experience widespread gambling advertising, increased accessibility (over 3000 scratch lottery locations and 15,000 video poker) and exposure to legalized gambling. None of these forms of gambling is legal for minors under age 18, and casino gambling is legal only for those aged 21 or over. Given this changed social context, how do adolescents perceive the risk of gambling?
In the present study, a discussion leader interviewed adolescents in small groups of up to 18 members. From these, 12 focus groups explored risks associated with gambling activities. Among them, two focus groups of participants were working in the Louisiana State University Health Science Center-Shreveport summer program for high school students. In addition, residents in ten residential treatment facilities, including detention centers, were invited to voluntarily participate in a group discussion. Because a previous study found high rates of problem gambling among those populations, residential treatment centers were chosen.4 There was high participation by minority adolescents in both community and residential groups, with equal gender distribution. The participants were assured anonymity in the sessions, which lasted about an hour. The sessions were audio taped, transcribed and sorted by common themes.5 The Major Risk Categories for gambling according to adolescents were as follows:
- Gambling to make money: means to an end
- Gambling to feel good: as an end in itself
- Gambling as an alternative to other crimes
- Risk in gambling activity itself
- Risk in being caught gambling, not the activity itself
- Risk in being caught cheating at the game, not gambling itself
- Perception of risk dependent on mood/drugs at time of choice
In the explanations of these categories below, quotations illustrate typical statements.
Category 1: Gambling To Make Money: as a Means to an End
Gambling is a means to an end when the goal is to hit the jackpot, buy clothes or drugs, get RICH, be independent and avoid asking parents for money. When gambling is a means to and end, one needs to quickly get big money to achieve timely gratification. "Parents don't give you money; you have to get your own." From the teen perspective, parents never give them enough money. Although the perceived pressure to have money arises from parents and peers, this expectation is also self-imposed.
Category 2: Gambling To Feel Good: as an End in Itself
The attraction for gambling that these adolescents feel is anticipation for positive outcomes. They see their friends gamble, and it feels good to win. "There is always a chance I might win." "I want to keep gambling because I am on a roll, and I want the feelings to last." To them, it feels good to play, it's fun and it's entertaining. This is easy, tax-free money.
Theme Category 3: As an Alternative to Other Crimes
These people view gambling as preferable to shooting others or stealing to get money. "You don't hurt anyone when you gamble."
Gambling occupies the time and is easier than a traditional job route to get money. Tired of school since seventh or eighth grade, they theorize that they need to gamble because they have no steady job. Some said they would not gamble if they had a job. "If you don't believe you can think, you might need to gamble to get money."
Category 4: Gambling Risks (split into five subcategories)
- Risk of personal harm may come from an opponent. "You can get stabbed, beaten, shot, killed in a fight over gambling. If you win, the loser may want his money back and start a fight." You might kill yourself over losing money or receive punishment from parents. Harm may depend on the location; it is not safe in a strange neighborhood.
- The risk of addiction comes from loss of personal control. "You can get hooked." This statement comes from adolescents who have seen pathological gamblers, maybe family members, and they do not want to become like those gamblers. They become scared that, if they won, they could not stop. They feel that they could quit a street game, but could be seduced to stay in a casino. Gambling becomes a problem if a person steals to play again.
- Others may cheat you or outsmart you. "Hustlers on boats know card tricks." "Boats only want your money." "They use crooked dice on boats." You won't lose your money on the streets like on boats. This is not a problem, they say, if you set a limit on the amount won or lost and then go home.
- You might cause harm to others if you lose personal control. "You might lose, get mad and want your money back." You might get vicious, hurt someone or even kill a person.
- It all depends on which game and the setting in which you play. Risk depends on the ease of concealment and frequency of participation.
Category 5: Risk of Being Caught Gambling
"You could serve jail time if caught writing hot checks for gambling or stealing for gambling." Adolescents think that gambling is not risky if it is done in private. However, you can be arrested for street games, gambling at school, or for cruelty to animals (e.g., betting on dog fights).
Category 6: Risk of Being Caught Cheating
"Others get mad if you cheat."
Category 7: Personal State at Time of Choice to Gamble
Adolescent perception of risk depends on both mental and physical states at the time of choice to gamble. Benefits may appear to outweigh risks if they are desperate. Risk seems lower under influence of drugs.
Adolescents in this sample perceived gambling as a positive means to obtain money quickly, often easier and better than obtaining education and a job, or better than resorting to other crimes to get money. They identified gambling as entertaining and pleasurable. In fact, many of the attitudes expressed by the adolescents resemble the cognitive distortions of adult problem gamblers. They think they can control gambling outcomes with their luck or skill and that people gain rather than lose money by gambling. Only the few adolescents who had experienced problem gambling in a family member identified the risk of problem gambling. Overall, favorable perceptions of gambling outweighed its dangerous or harmful aspects. Before they complete gambling disorder screening, adolescents need awareness that gambling problems exist and can affect them.
Preventive gambling education is needed at the middle-school level to influence children who are exposed to distortions about gambling that come from their peers, advertising and community. Adolescent residential treatment sites need gambling disorder assessment because of the increased prevalence of gambling disorders in these sites. Focused educational interventions may be necessary to help the adolescent understand the link between gambling and gambling-related problems.t
Dr. Lera Joyce Johnson is a Developmental and Experimental Psychologist who currently teaches as an Assistant Professor of Psychology at Centenary College of Louisiana in Shreveport. She joined the Gambling Studies Unit at LSUHSC-S in 1997 and has presented and published with Dr. James R. Westphal on gambling topics. She may be contacted by writing to: Lera Joyce Johnson, Ph.D., Centenary College of LA, PO Box 41188, Shreveport, LA 71134-1188.
Dr. James R. Westphal graduated from the University of Wisconsin-Madison with a Bachelor's Degree in Biochemistry and a M.D. degree. He completed his psychiatric residency at Stanford Medical Center and currently is a Professor of Clinical Psychiatry and Director of the Consultation Liaison Service at LSU Health Sciences Center in Shreveport. Dr. Westphal was Co-Chair of the Louisiana Joint Legislative Committee on Compulsive Gambling and is a member of the Board of Directors of the Louisiana Council on Compulsive Gambling.
References
1. Shaffer, H.J., Hall, M.N., and Vander Bilt, J. Estimating the Prevalence of Disordered Gambling Behavior in the United States and Canada: A Meta-Analysis. Harvard Medical School, Division on Addictions, (1997).
2. National Research Council. Pathological Gambling: A Critical Review, Washington, DC: National Academy Press, (1999).
3. Volberg, R.A. The Prevalence and Demographics of Pathological Gamblers: Implication for Public Health. Am J Pub Health, vol. 84, pgs. 237-241, (1994).
4. Westphal, J.R., Rush, J.A., Stevens, L., and Johnson, L.J. "Gambling behavior of adolescents in residential placement in Northwest Louisiana." Southern Medical Journal, vol. 91(11), pgs. 1038-41, (1998).
5. Glaser, B.G., and Strauss, A.L. The Discovery of Grounded Theory: Strategies for Qualitative Research. New York: Aldine de Gruyter, (1967). |
