Neuroscience, Longitudinal Youth Prevalence Studies Yield New Findings About Disordered Gambling

Two recently published studies have yielded new information about disordered gambling that will not only help guide future treatment methods but also assist public officials in formulating policy decisions to address the disorder.

The first-ever magnetic resonance imaging (MRI) study of disordered gamblers, conducted by a team of scientists from Yale University School of Medicine, the Connecticut Council on Problem Gambling and the Vanderbilt University School of Medicine (Potenza, Steinberg, Skudlarski et al., 2003), revealed that disordered gamblers exhibited different neurological patterns than control subjects when viewing gambling scenarios.

The study measured gambling urges and brain functions among individuals who viewed videotaped scenarios of various happy, sad and gambling scenarios. Participants included 13 control subjects and 14 men diagnosed with a gambling disorder. Disordered gamblers and control subjects exhibited nearly identical subjective and neurological responses to the happy and sad scenarios. However, compared with the control sample, disordered gamblers reported significantly greater urges after viewing gambling scenarios. Fully 10 out of 10 disordered gamblers, compared with three out of 10 control subjects, reported gambling urges upon viewing these scenarios.

Most significantly, the disordered gamblers exhibited decreased neurological activity in the frontal, paralimbic and limbic brain structures - the brain regions involved in impulse regulation - when presented with gambling scenarios. These decreases in brain activity were recorded before the subjects indicated they felt the urge to gamble, illuminating the difficulties facing individuals who experience pathophysiologic responses before they are consciously aware of a desire to engage in pathological behaviors. 

These results indicate disordered gambling may share a close relationship with other non-drug disorders associated with impaired impulse control. The neurological changes evident in the disordered gamblers reflect clinical characteristics for the group, including a greater tendency for increased impulsiveness, impaired decision-making abilities and minimal contemplation of anticipated behavior consequences. 

The study has profound treatment implications because the urges associated with impulse control disorders such as disordered gambling, substance use disorders and obsessive-compulsive disorders are important targets for therapeutic interventions.

Scientists involved in the study indicate future examinations involving female problem gamblers and larger sample sizes, as well as studies directly comparing brain activity among disordered gamblers, chemically dependent individuals and obsessive-compulsive individuals, would strengthen this research and lead to even more important treatment conclusions. The study, funded by a grant from the National Center for Responsible Gaming, was published in August in the journal Archives of General Psychiatry.

Another recent journal article - this one published in the Journal of Abnormal Psychology - reported on the findings of an 11-year study of the prevalence of disordered gambling among college students, which found that the rate of disordered gambling among these students was lower than that found in previous studies.

According to the research (Slutske, Jackson, & Sher, 2003), which tracked a sample of 468 University of Missouri students from 1987 through 1999, full sample lifetime prevalence rates of problem gambling observed at each interval of the study were between 3.2 and 3.8 percent, much lower than the 5.6 percent prevalence rate of lifetime problem gambling reported among college students in previous research (Shaffer & Hall, 2001). 

Authors of the study defined "problem gambling" as the presence of one or more criteria for pathological gambling as defined by the most recent DSM criteria available at the time of each interview, which took place in year one, four, seven and 11.

Over the course of the study, more than 90 percent of participants in the study reported no symptoms for problem gambling across all years they were assessed. In the three years it was measured, the past-year rate of gambling problems was lowest at year 11 (1.8 percent).

Only three people reported gambling problems in both years one and four, and only one person experienced problems three years in a row. Further, only three individuals experienced different periods of problems separated by one or more years of no problems. These data suggest that gambling problems are not a persistent condition for former college students, but that individuals can more fluidly fall in and out of gambling problems.

The study also indicates that young adults within the sample who experienced and then conquered a gambling problem were highly unlikely to return to the behavior. These findings challenge traditional notions that problem gambling is a chronic and progressive disorder, allowing for the concept that some individuals may have the ability to "mature out" of their problem gambling behavior.

Authors of the research pointed to several limitations of the study, including the relative homogeneity of the sample demographics, as well as limited access of the sample group to gambling opportunities in Missouri during the course of the study. The Missouri State Lottery had only been established one year before the study began, and from 1986 to 1989, the only legal gaming activities in the state were the lottery and bingo. A riverboat casino opened across the river in Illinois in the seventh year of the study.

Despite these limitations, the longitudinal design of the study and the high retention rate of participants - 84 percent at year 11 - provide a reliable information base for long-term analysis of gambling habits of one segment of young Americans who attended college. The report suggests additional research into problem gambling among young adults is needed to better explain the relationships between gambling, maturation, life experience and other factors.

SOURCES

Potenza, Marc N., Steinberg, Marvin A., & Skudlarski, 
   Pawel, et al. (2003). Gambling Urges in Pathological 
   Gambling, Archives of General Psychiatry, 60, 828-836.

Slutske, W.S., Jackson, K.M., & Sher, K.J. (2003). The 
   natural history of problem gambling from age 18 
   to 29. Journal of Abnormal Psychology, 112 (2), 263-
   274.

Shaffer, H.J., & Hall, M.N. (2001). Updating and Refining 
   meta-analytic prevalence estimates of disordered 
   gambling behavior in the United States and Canada. 
   Canadian Journal of Public Health, 92 (3), 168-172.