gambling-related problems in adolescence · dr. tobias hayer “gambling-related problems in...

Gambling-related problems

in adolescence

Development and validation of a

new screening instrument

Dr. Tobias Hayer

University of Bremen (Germany)

10th European Conference on Gambling Studies and Policy Issues

September 10, 2014, Helsinki (Finland)

… Gambling among adolescents …

Dr. Tobias Hayer

“Gambling-related problems in adolescence“

Youth and problem gambling: Prevalence rates (I) - Selected findings from Europe (N ≥ 500) -

Fisher (1999)

England / Wales

Johansson &

Götestam (2003)

Norway

Moodie &

Finnigan (2006)

Scotland

Ólason et al.

(2006)

Iceland

Skokauskas &

Satkeviciute

(2007)

Lithuania

Ipsos Mori (2009)

England / Wales /

Scotland

Sample

(Age)

9,774 students

(12-15 years)

3,237 adolescents

(12-18 years)

1,981 students

(11-16 years)

3,511 students

(13-15 years)

835 students

(10-18 years)

8,958 students

(11-15 years)

Screening

instrument DSM-IV-MR-J DSM-IV DSM-IV-J

SOGS-RA /

DSM-IV-MR-J

SOGS-RA /

DSM-IV-MR-J DSM-IV-MR-J

At-risk

gamblers (%) --- 3.5 15.1

4.1 /

3.7

10.5 /

9.1 3.4

Problem

gamblers (%) 5.6 1.8 9.0

2.8 /

1.9

5.2 /

4.2 2.0

Dr. Tobias Hayer


Villella et al.

(2011)

Italy

Tozzi et al.

(2013)

Switzerland

Colasante et al.

(2014)

Italy

Dodig (2014)

Croatia

Hanss et al.

(2014)

Norway

Kristiansen &

Jensen (2014)

Denmark

Lupu & Todirita

(2013)

Romania

Sample

(Age)

2,853 students

(13-20 years)

1,102 students

(15-20 years)

5,930 students

(15-19 years)

1,948 students

(14-20 years)

2,055

adolescents

(17 years)

2,223 students

(11-17 years)

1,032 students

(11-19 years)

Screening

instrument SOGS-RA SOGS-RA SOGS-RA CAGI PGSI SOGS-RA

GA 20

Questions

At-risk

gamblers (%) --- 4.3 5.9 16.9 1.5 4.5 23.5

Problem

gamblers (%) 7.0 1.3 3.1 12.3 0.2 1.3 3.5

Dr. Tobias Hayer


Youth and problem gambling: Prevalence rates (II) - Selected findings from Europe (N ≥ 500) -

Hurrelmann et al.

(2003)

Baumgärtner

(2009)

Duven et al.

(2011)

Walther et al.

(2012)

Ludwig et al.

(2012)

Sample 5,009 students

(13-19 years)

1,132 students

(14-18 years)

3,967 students

(12-18 years)

2,553

(vocational)

students

(12-25 years)

6,192 students

(9th/10th class)

Prevalence

participation

lifetime (%)

62.0 82 64.3 --- ---

Prevalence

participation

past 12 months

(%)

39.9 20

(past 30 days) 41.2 33.4 44.3

Prevalence

problem gambling

(%)

2.96

(DSM-IV-MR-J) ---

2.2

(DSM-IV-MR-J)

1.3

(SOGS-RA) ---

Dr. Tobias Hayer


Youth (problem) gambling – Evidence from Germany

Mean gambling prevalence estimates for different population segments (meta-analysis; Shaffer & Hall, 2001)

Classification Adults (%) Adolescents (%)

Level 3 – lifetime 1.92 3.38

Level 2 – lifetime 4.15 8.40

Level 3 – past year 1.46 4.80

Level 2 – past year 2.54 14.60

Level 2 = at-risk gambling; Level 3 = pathological gambling

For adolescents problem gambling rates appear to be higher than those of adults!

Dr. Tobias Hayer


Youth problem gambling – Evidence from North America

But why?

Dr. Tobias Hayer


Hypothesis 1: Developmental effect

Psychosocial development:

period marked by heightened risk taking, exploration, identify formation, peer

group influences, instability

Brain development:

relative immaturity of frontal cortical and subcortical monoaminergic systems

that underlie impulsive behavior

Dr. Tobias Hayer


Hypothesis 2: Cohort effect

Age-related differences in prevalences of problem gambling may be due to a cohort effect (i.e., effects of historical changes only influence certain individuals)

Prime example: Internet-based gambling

Dr. Tobias Hayer


Hypothesis 3: Measurement effect

No gold standard exists; screening instruments used (e.g., SOGS-RA; DSM-IV-J/DSM-IV-MR-J) stem mainly from clinical settings and have originally been developed for

adults; none has undergone rigorous psychometric evaluation

Dr. Tobias Hayer


A novelty: CAGI

Tremblay, J., Stinchfield, R., Wiebe, J. & Wynne, H. (2010).

Canadian Adolescent Gambling Inventory (CAGI): Phase III final report. Ottawa: Canadian Centre on Substance Abuse.

Dr. Tobias Hayer


CAGI – Overview

“Bottom-up“ process: Development of a scale specifically for adolescents

Phase 1: Literature review and consultation with clinicians, experts, and youth

Phase 2: Testing items with N=2,394 students from secondary schools

Phase 3: Testing with high risk youth populations (cross-validation)

Measures multiple domains of (problem) gambling:

Types of gambling activities, frequency of participation for and time spent on each gambling

activity, total money spent gambling and 24 items related to negative consequences

(psychological, social, financial, loss of control; an overall score includes items from these

subscales as well as other items to provide a global severity score)

Body of evidence for reliability, validity, and classification accuracy is still limited

King, Abrams & Wilkinson (2010): N=581 students at a Midwestern university (M=19,6 years)

Dodig (2014): N=1,948 Croatian high-school students (M=16,6 years)

Other studies are currently under way (e.g., in Spain and the US)

Goal and research design – Overview

Phase 1 – Development of the screening instrument

Phase 2 – Validation of the screening instrument

Dr. Tobias Hayer


Establish the “Fragebogen zu glücksspielbezogenen Problemen im Jugendalter“ (FGP-J; Hayer, Meyer & Petermann; target group: 13-20 years old)

Literature review (risk factors)

Analysis of available instruments

Expert survey (N=45; RR=86.5%)

One focus group and two qualitative interviews with adolescents

Dr. Tobias Hayer


FGP-J – Preliminary version (24 items)

24 items from 10 domains; 4-point-Likert scale (very often, often, sometimes, never); time frame: past 6 months; introductory definition of gambling

Domain Item (examples)

Preoccupation (n=2) “How often did you have the feeling that your gambling has

become too important in your life?”

Functionality (n=2) “How often did you gamble because you urgently needed

money?”

Loss of control (n=4) ”How often did you gamble longer than you wanted?”

Tolerance (n=1) ”How often did you increase your bets so that gambling

continues to be thrilling and exciting?”

Dr. Tobias Hayer


FGP-J – Preliminary version (24 items)

Domain Item (examples)

Withdrawal-like symptoms (n=1) ”How often did you feel bad when trying to cut down

gambling?”

Chasing (n=2) “How often did you try to directly win back money you

have lost?”

Dissimulation (n=2) “How often did you use excuses to gamble?”

Negative consequences (n=5) “How often did you skip leisure activities (e.g., sports or

music) to gamble?

Money issues (n=1) “How often did you borrow money to gamble?”

Problem perception (n=4) “How often did you have the feeling that you are gambling

too much?”

Adolescents who seek

professional help

(i.e., addiction counselling)

n≈50

Adolescents from different

risk segments (e.g., sports clubs,

youth welfare services) n≈100

School survey

(adolescents with and without

gambling experience) n≈750

Dr. Tobias Hayer


Validation – Procedure (ongoing)

Online survey

(adolescents with gambling

experience)

n≈100

Overall sampling goal:

N≈1,000

Dr. Tobias Hayer


Validation – Contents of student survey

Construct / variables Validation

Socio-demographics Risk groups

Gambling activities Convergent validity

Problem gambling (FGP-J) Target construct

Problem gambling (Lie/Bet-Questionnaire) Convergent validity

Leisure-time activities Correlation

Impulsivity Causal risk factor

Self-efficacy and life satisfaction Protective factors

(Mal)adaptive coping and emotional strain Risk/protective factors

Agreeableness (personality trait) Discriminant validity

Dr. Tobias Hayer


Reliability and item analysis – Issues to be considered

Internal structure (factor analysis)

Internal consistency (Cronbach‘s alpha)

Stability (test-retest realibility)

Item characteristics: Item difficulty

Item characteristics: Item discrimination

Item characteristics: Item homogeneity

Dr. Tobias Hayer


Validation – Online survey

http://ww2.unipark.de/uc/hayer/

Gambling definition

Gambling activities (including the fake item “Blizzo“)

Dr. Tobias Hayer


Subsequent research

Young problem

gambler?

Conduct a representative school survey (“norm sample“)

Translate the instrument and plan a cross-national / cross-cultural study

Cross-validate the instrument with different high-risk groups

For further information

Hayer, T., Meyer, G. & Petermann, F. (2014). Glücksspielbezogene Probleme unter

Jugendlichen: Eine kritische Auseinandersetzung mit den gängigen Screening-

Instrumenten [Gambling-related problems among youth: A critical review of current

screening instruments]. Kindheit und Entwicklung, 23, 174-183.

Hayer, T. & Griffiths, M.D. (2014, in press). Gambling. In T.P. Gullotta, M. Evans & R.W.

Plant (Eds.), Handbook of adolescent behavioral problems: Evidence-based

approaches to prevention and treatment. New York: Springer.

Hayer, T. (2012). Jugendliche und glücksspielbezogene Probleme: Risikobedingungen,

Entwicklungsmodelle und Implikationen für präventive Handlungsstrategien

[Adolescents and gambling-related problems: Risk factors, developmental models,

and implications for preventive actions]. Frankfurt/M.: Peter Lang.

Thank you for your attention!

Dr. Tobias Hayer University of Bremen

Institute of Psychology and Cognition Research Grazerstr. 4

28359 Bremen Germany

Tel. +49 / 421 218-68708 E-Mail: [email protected]

Web: http://www.tobha.de

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