Epidemiology Of Pathological Gambling

Epidemiological studies conducted during the 1980s in New York, New Jersey, Maryland, and Quebec yielded similar estimates. Approximately 1.5 percent of adults were found to be probable pathological gamblers and an additional 2.5 percent were found to have some gambling-related problems. In contrast, a lower prevalence was found in Iowa. Unlike the other jurisdictions stud ied, in which legal gambling was well established, Iowa had just initiated a state lottery at the time of the survey. The Iowa rate climbed over the next few years, and subsequent studies by Dr. Rachel Volberg found that the prevalence of gambling problems in several states correlated with the state's per capita lottery sales and the number of years of exposure of the state's population to legal gambling.

Dr. Howard Shaffer of Harvard and his colleagues conducted a meta-analysis of 120 epidemiological studies of gambling problems in the scientific literature to try to approximate an overall prevalence rate. They found that among adults, about 1.6 percent had a diagnosis of pathological gambling at some time in their lives and an additional 3.9 percent had gambling problems. Criteria for a current diagnosis was met by about 1.1 percent, while 2.8 percent had current gambling problems of a lesser severity.

In general-population studies in the United States, males outnumber females among probable pathological gamblers by a ratio of about two to one. This is in sharp contrast to male to female ratios observed in treatment programs and GA groups, which are closer to eight or nine males to one female. Some general-population studies in the United States have also found an overrepre-sentation of nonwhite adults (blacks and His-panics) among probable pathological gamblers; but these groups, like women, are also underrepre-sented in treatment and GA populations.

Although less is known about the prevalence of pathological gambling among adolescents than among adults, several surveys of high school students revealed that the vast majority gamble to some extent and that many have problems. For example, a New Jersey study of nearly 900 students found that over 90 percent had gambled at some time in their lives and about 35 percent did so at least weekly. Approximately 5.7 percent of these eleventh- and twelfth-grade students—9.5 percent of boys and 2 percent of girls—were classified as probable pathological gamblers. The Shaffer study found consistently higher rates of both gambling problems and pathological gambling in adolescent and college-age populations.

Established risk factors for pathological gambling include being male, having a family history of heavy or problem gambling or of parental alcoholism, and early interest and participation in gam bling activities. In addition, some studies show higher rates of problems in people who are non-Caucasian, unmarried, have less than a high school education, have less than average income, or are under the age of thirty.

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