The impact of childhood maltreatment on youth gambling problems Jeffrey L. Derevensky, Ph.D. Jennifer Felsher, Ph.D. Rina Gupta, Ph.D. McGill University.

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  • The impact of childhood maltreatment on youth gambling problems

    Jeffrey L. Derevensky, Ph.D.Jennifer Felsher, Ph.D.Rina Gupta, Ph.D.

    McGill University

    International Centre for Youth Gambling Problems and High-Risk Behaviors

    www.youthgambling.com

    Nova Scotia Responsible Gambling Annual ConferenceOctober, 2011

  • BackgroundAdolescent gambling and problem gambling rates have been well established

    Considerable knowledge has been gained concerning the correlates associated with youth problem gambling

    There has been a growing interest in identifying predisposing factors for risk of adolescent problem gambling

  • Etiology of Problem GamblingBlaszczynski and Nower (2002) identified three distinct subgroups of pathological gamblers: Behaviourally conditioned problem gambler Emotionally vulnerable problem gambler Antisocial impulsivist problem gamblerEmotionally vulnerable problem gambler: Anxiety Depression Poor coping and problem solving Experience negative life experiences Use gambling to modulate affective states

  • Jacobs General TheoryJacobs (1986) General Theory of Addiction Importance of childhood maltreatment

  • MaltreatmentIncreased chronic stressMaladaptive psychological adjustmentIncreased social adjustment difficultiesMental health problemsIncreased risk for addictive problems (substance abuse disorders)

  • Childhood MaltreatmentPhysical abuseEmotional abuseSexual abuseEmotional neglectPhysical neglect

  • Current ResearchTo determine whether childhood maltreatment is a risk factor in the development of gambling problemsInvestigated role of life experiences (stress, psychiatric symptomatology and resilience) as contributing factors for youth with gambling problems

  • Participants566 males Mean age = 18.72757 femalesMean age = 18.61Total 1327Mean age = 18.66

  • Instruments

    DSM-IV Criteria for Pathological Gambling - (APA, 2000)

    Gambling Activities Questionnaire (GAQ) - (Gupta & Derevensky, 1996)

    The Adolescent Diagnostic Interview - Light (ADI-L) - (Winters & Henly, 1993; Winters, Stinchfield, Fulkerson, & Henly, 1993)

    Childhood Trauma Questionnaire (CTQ) - (Bernstein & Fink, 1998)

    Perceived Stress Scale (PSS) - (Cohen, Kamarck, & Mermelstein, 1983)

    Brief Symptom Inventory (BSI) - (Derogatis, 1993)

    The Personal Style Inventory (PSI) - (Sheridan, 2003)

  • Table 1 Gambling Severity by Gender DSM-IV score (0-2). DSM-IV score (3-4). DSM score ( 5). 4 participants did not complete the GAQ or DSM-IV.

  • Table 2 Involvement in Gambling Activities: Gender Differences Percentage. Refers to gambling less than once a week. Refers to gambling once a week or more*p < .05. **p < .001.

    ActivitiesGambling InvolvementOccasionalRegularMaleFemaleMaleFemaleCards**37.728.77.72.9Scratch tickets*41.746.91.93.0Lottery draws30.331.23.72.0Sports lottery**19.53.34.30Sports pools**28.17.03.70.1Bingo**9.918.90.50.8Casino32.625.52.50.1VLT machines**27.518.72.50.3Internet*2.82.60.90Stock Market**10.43.22.30.3Racetrack**4.01.10.90.1Other11.32.12.30.4

  • Table 3a Severity of Childhood Maltreatment by Gender Percentage. CTQ = Childhood Trauma Questionnaire. Severity of maltreatment based on standardized cut scores. *p < .05.

    CTQ SubscalesDegree of Maltreatment (MT) None or minimalLow-moderateModerate-severeSevere-extremeTotal MTEndorsementEmotional Abuse* Male 68.620.75.65.131.4 Female 61.025.07.56.539.0 Total64.323.16.75.935.7Physical Abuse Male 79.010.84.95.321.0 Female82.27.94.55.417.8 Total80.89.14.75.419.2Sexual Abuse Male 89.44.94.21.410.5 Female85.44.65.84.114.5 Total87.24.85.12.912.8

  • Table 3b Severity of Childhood Maltreatment by Gender Percentage. CTQ = Childhood Trauma Questionnaire. Severity of maltreatment based on standardized cut scores. *p < .05.

    CTQ SubscalesDegree of Maltreatment (MT) None or minimalLow-moderateModerate-severeSevere-extremeTotal MTEndorsementEmotional Neglect* Male 56.329.48.75.643.7 Female64.526.05.44.135.5 Total61.027.46.84.839.0Physical Neglect Male 66.119.89.24.933.9 Female75.714.16.53.724.3 Total71.616.67.64.228.4

  • Table 4a Severity of Childhood Maltreatment by Gambling Severity Percentage CTQ = Childhood Trauma Questionnaire. Severity of maltreatment based on standardized cut scores. *p < .05. **p < .001.

    CTQ subscaleDegree of Maltreatment None or minimalLow-moderateModerate-severeSevere-extremeTotal MT EndorsementEmotional Abuse**Non gambler62.521.28.18.137.4Social gambler66.822.65.94.733.2At-risk gambler38.236.414.510.961.8Pathological gambler53.625.07.114.346.4 N = 1320Physical Abuse**Non gambler84.86.03.95.315.2Social gambler81.98.74.84.618.1At-risk gambler50.929.17.312.749.1Pathological gambler67.910.73.617.932.2N = 1320Sexual Abuse**Non gambler84.84.26.44.615.2Social gambler89.04.74.12.211.0At-risk gambler72.77.314.55.527.3Pathological gambler75.07.110.77.124.9N = 1319

  • Table 4b Severity of Childhood Maltreatment by Gambling Severity Percentage CTQ = Childhood Trauma Questionnaire. Severity of maltreatment based on standardized cut scores. *p < .05. **p < .001.

    CTQ subscaleDegree of Maltreatment None or minimalLow-moderateModerate-severeSevere-extremeTotal MT EndorsementEmotional Neglect**Non gambler61.524.48.55.738.6Social gambler62.627.75.83.937.4At-risk gambler43.634.59.112.756.3Pathological gambler32.135.721.410.767.8N = 1316Physical Neglect** Non gambler74.914.16.44.625.1 Social gambler72.016.87.73.628.1 At-risk gambler63.618.212.75.536.4 Pathological gambler33.333.311.122.266.6N = 1325

  • Figure 1: Moderate to extreme maltreatment by gambling severity

  • Table 5a Childhood Maltreatment by Gender and Gambling Severity CTQ = Childhood Trauma Questionnaire. DSM-IV score (0-2). Combined at-risk and probable pathological gambling group (DSM-IV score 3). * p < .05. ** p
  • Table 5b Childhood Maltreatment by Gender and Gambling Severity CTQ = Childhood Trauma Questionnaire. DSM-IV score (0-2). Combined at-risk and probable pathological gambling group (DSM-IV score 3). * p < .05. ** p
  • Table 6a Severity of Childhood Maltreatment by Substance Group Percentage. CTQ = Childhood Trauma Questionnaire. Severity of maltreatment based on standardized cut scores. *p < .05. **p < .001.

    CTQ subscaleDegree of MaltreatmentNone/ minimalLow-moderateModerate-severeSevere-extremeTotal MT EndorsementEmotional Abuse* No substance problems68.220.96.24.731.8 Substance abuse61.923.46.58.338.2 Substance dependence55.228.89.26.844.8N = 1308Physical Abuse* No substance problems84.77.43.64.215.2 Substance abuse76.612.25.06.123.3 Substance dependence74.410.86.88.025.6N = 1308Sexual Abuse No substance problems89.04.64.51.911.0 Substance abuse86.34.06.13.613.7 Substance dependence83.66.05.64.816.4N = 1304

  • Table 6b Severity of Childhood Maltreatment by Substance Group Percentage. CTQ = Childhood Trauma Questionnaire. Severity of maltreatment based on standardized cut scores. *p < .05. **p < .001.

    CTQ subscaleDegree of MaltreatmentNone/ minimalLow-moderateModerate-severeSevere-extremeTotal MT EndorsementEmotional Neglect** No substance problems66.324.25.54.033.7 Substance abuse55.830.27.96.144.2 Substance dependence51.833.39.65.248.1N = 1304Physical Neglect* No substance problems74.715.95.93.525.3 Substance abuse69.814.79.46.130.2 Substance dependence64.421.110.04.435.5N = 1308

  • Table 7a Childhood Maltreatment by Gender and Substance Group CTQ = Childhood Trauma Questionnaire. *p < .05. **p < .001.

    CTQ subscalesSubstance GroupsNo Substance Use ProblemsSubstance AbuseSubstance DependenceNMSDMSDMSDEmotional Abuse** Male5597.653.188.234.148.553.60 Female7468.073.689.084.119.803.93 Total13057.923.528.654.149.073.78Physical Abuse** Male5606.212.156.662.897.283.69 Female7476.212.656.833.196.783.24 Total13076.212.496.743.047.083.52 Sexual Abuse* Male5605.341.435.321.355.692.58 Female7475.602.306.343.666.393.79 Total13075.512.045.832.795.983.14

  • Table 7b Childhood Maltreatment by Gender and Substance Group CTQ = Childhood Trauma Questionnaire. *p < .05. **p < .001.

    CTQ subscalesSubstance GroupsNo Substance Use ProblemsSubstance AbuseSubstance DependenceNMSDMSDMSDEmotional Neglect** Male5609.494.239.804.4110.304.24 Female7468.443.929.414.229.824.37 Total13068.814.079.614.3110.104.29Physical Neglect* Male5606.802.326.902.797.573.09 Female7486.362.246.972.726.592.27 Total13086.512.286.932.757.162.82

  • Figure 2: Moderate to extreme maltreatment by substance group

  • Table 8 Psychological Symptoms by Gender and Gambling Group BSI = Brief Symptom Inventory. DSM-IV score (0 - 2). Combined at-risk and probable pathological gambling group (DSM-IV score 3). *p < .05. **p < .001.

    BSIGambling GroupsNon GamblerSocial GamblerProblem GamblerNMSDMSDMSDGlobal Severity Index** Male544.54.55.51.52.74.80 Female742.65.69.67.641.08.89 Total1286.62.65.61.61.83.83Positive Symptom Total* Male55317.1114.1516.2612.9619.8516.29 Female74418.6113.6720.1414.0628.2014.87 Total129718.0513.8418.5313.7421.9416.27Positive Symptom Distress* Male5521.39.681.43.601.56.79 Female7421.55.751.51.631.89.77 Total12941.49.721.49.621.64.79

  • ConclusionsGeneral gambling prevalence rates:78% of young adults reported gambling in past year (81% males; 76% females)20% are gambling at least weekly2.1% severe gambling problems (pathological gambling) (4.1% M; 0.7% F)4.2% considered at-risk gamblers (7.1% M; 2.0% F)

  • MaltreatmentStrong linear trend for each form of maltreatment (emotional abuse, physical abuse, sexual abuse, emotional neglect, physical neglect) related to gambling problemsFewest problems occurring for non-gamblers and most for pathological gamblersAmong adolescents and young adults who reported maltreatment, 10.9% of at-risk gamblers and 14.8% of pathological gamblers report their maltreatment impacted their daily life

  • At-risk gamblers more likely to report emotional abuse and neglect

    Pathological gamblers more likely to report emotional and physical neglect

    Sexual abuse least form of reported abuse. However, twice as many at-risk and pathological gamblers reported some form of sexual abuse compared to non-gamblers and social gamblers.

  • No significant gender findings (possibly due to small number of female problem gamblers)

    Female problem gamblers reported elevated mean scores on emotional and physical abuse subscales

    Male problem gamblers reported higher scores on sexual abuse subscale

    Across all psychological system subscales of the Brief Symptom Inventory, at-risk and pathological gamblers reported more problems

  • Similar trends were for substance abuse

    Evidence appears to support both Jacobs (1986) and Blaszczynski and Nowers (2002) theories

    Finally, McCormick, Delfabbro & Denson (2011) in Australia recently reported similar findings

  • ImplicationsClinicians need to directly assess for maltreatment and address unresolved issues

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