For most individuals, gambling is a social activity enjoyed in moderation. Social gambling is defined by the American Psychiatric Association as "gambling which lasts for a limited amount of time with predetermined acceptable losses" (APA, 1994, p. 617). However, for some, gambling becomes a compulsion, an activity which is carried out in the face of negative consequences. The official definition of pathological gambling, as defined in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (APA, 1994) is as follows:
Pathological Gambling: Persistent and recurrent maladaptive gambling behavior that disrupts personal, family, or vocational pursuits1.
For the purposes of this study we will use the term "problem gambling" rather than pathological gambling. The estimates of problem gambling derived from this survey are not based on clinical examinations, rather, they are estimates derived from surveys. Thus, we will use non-clinical terminology to describe persistent gambling behavior which results in self-reported problems such as truancy or conflict with family and friends.
Current research suggests that youth gambling occurs on a continuum of involvement from no gambling at all to occasional gambling, to over-involvement (Stinchfield and Winters, 1998). In order to describe the range of problems associated with gambling we use the South Oaks Gambling Screen Revised for Adolescents (SOGS-RA) developed at the University of Minnesota (Winters, Stinchfield and Fulkerson, 1993a). We then classify adolescents based on their SOGS-RA score using the level system as proposed by Shaffer and Hall (1996).
We use the level system for at least two reasons. First, the level system offers a common sense approach to describing the continuum of gambling pathology. Historically, there has been no consensus about how to define pathological gambling in adolescents. However, since the publication of Shaffer and Hall's proposed level system, other researchers have begun to adopt this approach to classifying problem gambling (Westphal, Rush, Stevens, Horswell & Johnson, 1998). Second, the level system is the only classification scheme which directly links various degrees of problem gambling with levels of intervention. Thus, the level system not only provides a straight forward approach to classifying gambling behavior, but links various levels of gambling with appropriate intervention. Table 1.1, below, describes the level system.
Because youth experience a wide range of problems associated with gambling, it is not useful to simply describe young gamblers as "problem gamblers" or "non-problem gamblers." The level system used in this report classifies young gamblers in terms of the degree of problems associated with gambling. As described in Table 1.1 below, level 1 gambling is "social gambling" or gambling which is not associated with any problems.
Level two gambling, or in-transition gambling, refers to gambling behavior which does not meet the diagnostic criteria for pathological gambling, but which does, nonetheless, appear to be somewhat problematic. Because the adult rates of problem gambling are lower than the adolescent rates, there is reason to believe that many adolescents who are classified as problem gamblers may not go on to become adult problem gamblers. Thus, a youth described as an in-transition gambler may be moving toward problem gambling, or may be moving away from problem gambling (Shaffer, Hall and Vander Bilt, 1997).
Finally, level three gambling refers to problem gambling. Adolescents described as level three gamblers report heavy gambling in the face of adverse consequences. This population is the target population for which treatment for pathological gambling may be necessary. Because the survey used for this report did not ask respondents to identify whether or not they wanted treatment we do not use the level 4 classification in the report.
Levels of Gambling Involvement |
Definition |
Possible Education, Prevention, Treatment Interventions |
SOGS-RA Score
|
Level 0: Non- Gambling |
Has never gambled |
¬ Educational awareness
|
0 |
Level 1: Non-Problem Gambling |
Gambles recreationally and does not experience any signs or symptoms of gambling-related disorder |
¬ Secondary Prevention |
_ 1 |
Level 2: In-Transition Gambling |
Gambler who experiences subclinical symptoms or displays signs of gambling problems, may be progressing either toward more serious symptoms (i.e., progression) or away from these symptoms (i.e., during recovery) |
¬ Tertiary prevention
|
2-3 |
Level 3: Gambling-Related Disorder with Impairment |
Gambler who meets diagnostic criteria as assessed by the SOGS-RA as impaired in psychological or sociological domains. |
¬ Tertiary prevention to minimize harm
|
_ 4 |
Level 4: Impaired Gambler who Displays Willingness to Enter Treatment |
Gambler who satisfies level 3 requirements and, in addition, displays interest in entering treatment |
¬ Treatment |
N/A |
For the reader not familiar with the prevention literature, primary prevention is defined as those efforts that delay or prevent the onset of activities that can lead to harmful gambling (Shaffer, H.J. & Hall, M.N., 1996, p. 207). Secondary prevention is defined as efforts aimed at minimizing the likelihood that level 1 gamblers will develop problems related to gambling (Shaffer, H.J. & Hall, M.N., 1996, p. 209). Tertiary prevention is then defined as those efforts that are taken with youth in order to minimize problems that exist with level 2 and level 3 gambling. This level of prevention could be associated with early treatment for level 2 and treatment for level 3 gamblers and defined as relapse prevention (Shaffer, J.J. & Hall, M.N., 1996, p. 209-210). Treatment would be defined as those activities associated with arresting the problem gambling behavior and minimizing the harm caused by that behavior.
1 The diagnosis is not made if the gambling behavior is better accounted for by a manic episode.
2 Adapted from Shaffer & Hall, 1996.