Gambling in children and adolescents

Question 1

What is pathological gambling?

Answer 1

Impulse control disorder, characterized by persistent and recurrent maladaptive gambling behaviour that leads to significant deleterious legal, financial, physical and psychosocial consequences. Cannot be during a manic episode

Question 2

What percentage of Ontario grades 7-12 students were involved with gambling in the previous year?

Answer 2

42%

Question 3

What percentage of Ontario grade 7-12 students meet criteria for pathological gambling?

Answer 3

2.8%

Question 4

What is legalized gambling?

Answer 4

Gambling managed and regulated by provincial/territorial government

Question 5

What are the Canadian prohibitions regarding legalized gambling?

Answer 5

Prohibited in minors (age 18-19)

Question 6

When do most pathological gamblers start gambling?

Answer 6

Before or during adolescence (mean age of onset 13)

Question 7

What are risk factors for developing a gambling problem?

Answer 7

1. Depression
2. Loss
3. Abuse
4. Impulsivity
5. Antisocial traits
6. Learning disabilities
7. Regular gambling (at least once per week)
8. Gamble to escape from problems and/or satisfy physical needs
9. Thoughts of gambling interfering with sleep
10. Thoughts of gambling interfering with vocational pursuits

Question 8

What are comorbidities for gambling problems?

Answer 8

1. Personality disorders (8.3 times higher odds of pathologic gambling)
2. Alcohol abuse (6.0 times higher)
3. Life-time drug use (4.4 times higher)
4. Mood disorders (4.4 times higher)
5. Substance abuse
6. Marijuana use
7. Poor grades
8. Delinquent behaviours
9. Conduct disorder
10. ADHD
11. Anxiety

Question 9

When should gambling behaviors be suspected by HCP?

Answer 9

1. Parental concern re: emotional health
2. Poor or worsening academic performance
3. Sleep problems
4. Money or possessions in the home go missing
5. Criminal activity i.e. theft
6. Known or suspected substance misuse
7. Circumstances when one would screen for substance abuse
8. Impaired relationships with family or friends
9. Comorbidities (alcohol abuse, substance abuse, ADHD, CD, anxiety, mood d/o)

Question 10

What questions can a HCP use to screen for a gambling problem?

Answer 10

1. Frequency (>1/wk)
2. Gambling more than planned (inability to respect personal limits)
3. Hiding gambling behaviors i.e. lying

Question 11

What primary prevention program products are available for adolescent gambling?

Answer 11

1. McGill University International Centre for Youth gambling Problems and High Risk Behaviors
2. “Don’t Gamble Away Our Future” by Taylor et al

Question 12

What parental practices are associated with increased adolescent gambling problems?

Answer 12

1. Parental gambling frequency and problems
2. Low levels of parental monitoring
3. Higher levels of inadequate disciplinary practices

Question 13

What parental practices are protective for adolescent gambling problems?

Answer 13

1. Higher levels of parental attachment

2. Higher parental supervision and monitoring

Question 14

How should pathologic gambling be treated?

Answer 14

Under the same paradigm as other behavioral addictions

Question 15

What should also be screened for in adolescents who are aware of their gambling problem?

Answer 15

Depression and suicide risk

Question 16

How should schools become proactive regarding gambling among students?

Answer 16

1. Make teachers and school counsellors aware that gambling behavior among youth entails risks, incld. school failure and absenteeism
2. School-based counsellors should talk to teens about the risks of gambling when they are aware of substance use
3. School boards should adopt and enforce a no-gambling policy within their schools

Question 17

What should federal/provincial/territorial governments that run gambling programs do?

Answer 17

1. Address the sociological and environmental impact of gambling on young Canadians
2. Address the cost/benefit ratio of the current situation.
3. Develop effective strategies to support youth and families afflicted by this public health phenomenon.
4. Assess, evaluate and control the potential impact of advertising on gambling initiation and maintenance on vulnerable populations, including children and youth.
5. Assess the potential impact of new gambling offerings on youth before implementation, to ensure that the harm from such initiatives is minimized.