The meta-analysis reference number for each study listed in Table is the same used by Shaffer et al.
National Gambling tax revenue Press US ; The perception of increased pathological and problem gambling is currently driving interest and concern among policymakers, treatment professionals, industry officials, gambling researchers, and the public. Data describing the extent of pathological and problem gambling are useful for many purposes, including planning public health services and medical services.
This chapter discusses the prevalence of pathological and problem gamblers among the general U. As limited by the available data, the discussion is often framed in terms of the proportion of pathological and problem gamblers reported in studies of U. Of particular concern is determining prevalence among reportedly vulnerable demographic groups, such as men, adolescents, the poor, the elderly, and minorities including American Indians.
We also attempt to examine trends in relation to porblem increased hoyle casino 2004 rapidshare files of legal gambling opportunities in the last decade. This chapter also makes comparisons with the prevalence rates of alcohol and drug abusers, to help put the magnitude of excessive gambling and related problems into perspective.
In Chapter 2 we described the difficulties involved in defining and measuring pathological gambling using various assessment instruments. Unfortunately, such differences are common in gambling for free games research literature on pathological and problem gambling Volberg, bwhich creates problems in estimating prevalence rates in the United States.
Another important limitation of the available prevalence research pertains to the different facets of the concept of prevalence. A prevalence estimate requires specification of the population tue geographical area represented and the time frame over which prevalence is defined Walker and Dickerson, Most of the prevalence research on pathological and problem gambling is specific about the population or area represented, but the time frames within which gambling behavior is assessed vary widely.
This variation is troublesome because the information of greatest prbolem relevance is generally the prevalence of current pathological or problem gambling, that is, estimates over a relatively recent but behaviorally representative time frame e.
The time frame most common in available research, however, is lifetime. Thus, many of those who are counted in prevalence research as being pathological or problem gamblers may have met screening or diagnostic criteria at some point during their lives, but did not manifest gambling problems at the time of the study.
Measuring pathological and problem gambling also requires distinguishing incidence from prevalence: Incidence is especially pertinent to policy questions involving the effects of increased gambling opportunities and changes in technology, industry practices, and regulation. There is almost no research that examines the incidence of pathological or problem gambling cases over a representative, recent time period.
Finally, literature on pathological and problem gambling rarely distinguishes, in an epidemiological sense, the difference between studiess of pathological and problem gambling and proportions of pathological and problem probkem. This distinction is made throughout the chapter to the extent allowed by the data available to the committee.
Perhaps the most serious limitation of existing prevalence research is that the volume and scope of studies are not sufficient to provide solid estimates for the national and regional prevalence of pathological and problem gamblers, or to provide estimates of changes in prevalence associated with expanded gambling opportunities and other recent secular trends.
Only three studies have attempted to measure the prevalence of pathological or problem gambling in the United States for more than bambling or a few states. At that time, illegal gambling was believed to be widespread, and the nation was facing the prospect of increased legalization of gambling. Accordingly, the survey concentrated on assessing American gambling practices and attitudes toward gambling. The scale that attempted to measure "compulsive gambling" was only one small component of the larger gambling survey Commission on the Review of the National Policy Toward Gambling, From the responses of 1, adults about behaviors over their lifetimes, "it was estimated that 0.
A combined total of 3. Although the findings of the survey were considered important, the researchers advised caution in interpreting the results because it was not clear that their measures could distinguish compulsive i. A second attempt to estimate the prevalence of pathological or problem gambling in the United States and Canada was the recent meta-analysis by Shaffer and colleagues Shaffer et al. As opposed to original research, which involves collection of new prevalence studies of problem gambling in the united states, meta-analytic research empirically integrates the findings of previously conducted independent studies.
On the basis of predetermined criteria, Shaffer et al. These studies represented adults and youth in the general population, college students, adults and youth in treatment or prison settings, and a variety of other special populations. To standardize the different terms used in the studies analyzed, Shaffer et al. Level 0 referred to nongamblers; Level pproblem described social or recreational gamblers who did not experience gambling problems; Level 2 represented gamblers with less serious levels of gambling problems problem gambling ; and Level 3 represented pathological gambling.
This meta-analysis concluded that combined pathological and problem gambling—what they termed disordered gambling—was a robust phenomenon, although the majority of Americans and Canadians gamble with little or no adverse consequences. The study found that lifetime prevalence rates among adults in the general population for both nations together were estimated at 1.
Past-year prevalence rates were estimated at 1. Prevalence rates among problme and other special populations were found to be substantially higher Shaffer et al. As part of its review of the pathological gambling literature, the committee undertook an analysis of the Shaffer et al. Although these 20 surveys do not represent all states and territories within the United States, or any reasonable purposive sampling of them, they nonetheless provide the best recent information about the prevalence of pathological and problem gambling in the United States that is currently available.
As described in more detail in the following sections, the gambling belize palace casino prevalence rates found in those studies were as follows:.
Most studirs, a third national prevalence study was commissioned by the National Gambling Impact Study Commission. Preliminary results, released while this report was in its final stages, estimated the lifetime prevalence rate of Type E i. The past-year prevalence rate for Type E adult gamblers was estimated to be 0. The NORC study estimates are discussed in more detail later in this chapter.
Table identifies the general population studies included prevalenxe the Shaffer et al. Table also shows that a variety of survey instruments for identifying pathological and problem gamblers was used in these studies. However, the South Oaks Gambling Screen SOGS and its variants have dominated practice so completely that it has been the de facto standard operationalization of pathological and problem gambling for adult populations.
As discussed in Chapter 2the SOGS instrument has been criticized as a measure of pathological or problem gambling in the general population, chiefly because it was originally developed for use in clinical settings Lesieur and Prevalence studies of problem gambling in the united states, and may produce a high rate of false positives Hollywood casino toledo blackjack rules, In particular, there is some evidence that the threshold values for pathological and problem gambling generally applied to SOGs scores yield overestimates of prevalence relative to the results of classification using the criteria from the DSM Shaffer et al.
Not shown in Tablebut relevant to interpretation of the limited available prevalence research, are the uneven methodological characteristics of the prevalence studies. Response rate, for instance, varied from 36 to 98 percent, with a median of 68 percent. These prevalence studies were also inconsistent in their coverage of the gambling items.
Some surveys asked all questions of all respondents, and others asked certain questions only of those who responded affirmatively to a prior question. For example, if people had never had financial problems from gambling, they might not be asked how much money they lost from prevalence studies of problem gambling in the united states. Finally, the data analysis in these studies consisted chiefly of frequency distributions and simple cross-tabulations, with little examination of missing data or other potentially biasing characteristics.
One useful approach for integrating information across studies of varying methodological quality is to use meta-analytic techniques to adjust for methodological differences, in an attempt to minimize any distortion in the cross-study mean that stems from gamb,ing differences. For instance, Shaffer et al.
They found, however, that there was neither a statistically significant relationship between that score and reported prevalence rates nor meaningful differences between unweighted tsudies means and those weighted by methodological quality. In light of these findings and the relatively small number of recent U. With the limitations of coverage and methodological quality in mind, the prevalence findings from the studies listed in Table statse discussed in the remaining portions of this section.
Rather high proportions of the adult populations in the states surveyed have participated in at least some gambling during their lives. Among the 20 surveys identified in Table that were conducted in the past 10 years i. However, there was great problrm across the years in which studies were conducted, across different types of gambling activities, and between states.
More indicative of the prevalence of currently active gamblers are the survey data for participation in gambling activities in the prevalencs year. Unfortunately, this information was less often collected than lifetime data. Eleven of the studies in Table that were conducted in the past 10 years reported gambling during the prior year. The proportion of respondents in those studies who reported any type of gambling in the past year ranged from 49 to 88 percent, prevalenec a median of 72 percent.
If this is representative, then approximately three-quarters of the adult population in the United States has participated in some form of gambling in any recent year. Table summarizes the information available from studies conducted in the past 10 years regarding the cognitive behavioral therapy gambling addiction and past-year participation in various specific forms of gambling.
These findings must be interpreted with some caution, since relatively few studies contributed to each category and the coverage and content of the surveys varied considerably. For example, illegal gambling showed the highest percentages of lifetime participation reported for any gambling activity ranging from 56 percent in Mississippi to 65 percent in New York —a curious finding given legalized forms of gambling in those states—but was reported in only two studies, both conducted in As Table indicates, lottery gambling and illicit gambling were generally reported as having the highest proportions of respondents who have participated sometime during their lifetime.
Following these are charitable games, casino gambling, pari-mutuel betting, sports betting, video lottery, and card games, all with the top casino similar participation rates. Games of skill and gambling in financial markets i. The more limited information from these surveys on past-year participation prevaoence specific types of gambling is similar to that for lifetime participation, but with lower proportions in all categories.
Lottery participation was highest, with the lowest proportions found among games of skill, pari-mutuel betting, gambling in financial markets, and charitable games. Table summarizes the prevalence rates of Level 2 problem and Level 3 casino advice gamblers identified in the general population surveys conducted during the past 10 years, virtually all of which were conducted at the state level.
The lifetime prevalence of pathological gamblers Level 3 across the 18 studies reporting that information river bend casino from 0. Estimates of combined lifetime problem and pathological gambler prevalence Levels 2 and 3 ranged from 2.
From a policy standpoint, the most relevant data are those reflecting pathological or problem gambling prevalence in the past year, that is, relatively recent activity. Percentages of past-year pathological and problem gamblers were reported in only 13 studies, all prsvalence between prevalence studies of problem gambling in the united states The New Mexico data were based on a modified DSM-IV instrument and showed substantially higher rates for both problem and pathological gambling.
If the New Mexico study is set aside as an outlier in the distribution, the remaining prevalence estimates cluster fairly closely. Problem gambling Level 2 ranged from 0. It is possible to calculate the shopping gambling of pathological and problem gamblers among those who gamble by examining the rates for only those survey respondents who reported any gambling in the past year.
The last two columns in Table show these estimates. The 10 percent prevalence rate reported in Mississippi was notably higher than in other states. If it is set aside as a possible statistical outlier, a more conservative prevalence estimate results, ranging from 2. This indicates that, sinceapproximately 3 to 7 percent of those who gambled in the year before problek surveyed reported Level 2 problem or Level 3 pathological gambling symptoms. Looking only at pathological gamblers Level 3 among those who reported having gambled in the year prior to being surveyed, the Mississippi estimate of 4.
Leigh casino aside that thd, the prevalence estimates in the other states surveyed ranged from 0. Thus, approximately 1 to 2 percent of those who gambled in the year prior to gamblingg surveyed reported symptoms consistent with pathological gambling.
While this report was in its final stages, preliminary results were released from the national survey conducted by NORC for the National Gambling Impact Study Commission. As only the third national survey of gambling problems ever carried out, this is an important contribution to research on problem gambling. These differences in procedure, instrumentation, and categorization make comparison with the largely SOGS-based surveys in Table questionable.
Nor is the NODS or the procedures by which it was yambling and scored sufficiently well validated to accept its estimates of the prevalence of pathological and problem gambling as definitive. Nonetheless, for the category of pathological gambling, the NORC estimates are similar to those reported here.This paper examines the results of prevalence studies of problem and pathological gambling that have been carried out in the United States. The discussion is. Only three studies have attempted to measure the or problem gambling in the United States for more than Limitations of Prevalence · Pathological and Problem · Vulnerable Populations. D. United States State/Territorial Adult Prevalence Studies of Problem Gambling E. Demographic Correlates of Problem Gambling.