factors influencing treatment-seeking behavior in female ...€¦ · stigmatization and gender...
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Factors influencing
treatment-seeking behavior
in female pathological gamblers
Universität Hohenheim, Gambling Research Center
Andrea Wöhr M.A.
Use of Treatment
“Only 7%–12% of those with a history of DSM-IV pathological gambling had sought either formal treatment or attended meetings of Gamblers Anonymous …”
(Slutske 2006: 300)
2Email: [email protected]
Universität Hohenheim
Forschungsstelle Glücksspiel
Prof. Dr. Tilman Becker
Michael Loeper / pixelio.de
Shame and Fear of Stigmatization
“Stigma and shame have been identified as major barriers to help-seeking for problem gambling“
(Hing et al. 2016b: 32)
3Email: [email protected]
Universität Hohenheim
Forschungsstelle Glücksspiel
Prof. Dr. Tilman Becker
Lucie Gerhardt / pixelio.de
Stigmatization of Gamblers
• Addictions attract high level of stigma
→ Individuals are perceived blameworthy for their behavior
→Problem gambling perceived as weakness ofcharacter or lack of self-control
(Hing et al. 2016b: 36-37)
4Email: [email protected]
Universität Hohenheim
Forschungsstelle Glücksspiel
Prof. Dr. Tilman Becker
Stigmatization and Gender
Concepts of gender:
• Risky behavior more likely to be tolerated in (young) men
(Hing et al. 2016a: 264)
5Email: [email protected]
Universität Hohenheim
Forschungsstelle Glücksspiel
Prof. Dr. Tilman Becker
Daniel Stricker / pixelio.de
Stigmatization and Gender
• Women seen in dependent role:“Because of historically defined gender roles for women as caregivers, nurturers, mothers, partners and homemakers, women risk being judged as irresponsible, unrespectable, incompetent and selfish if they display problem-gambling behaviours…” (Hing et al. 2014: 72-73)
6Email: [email protected]
Universität Hohenheim
Forschungsstelle Glücksspiel
Prof. Dr. Tilman Becker
Internalization of Stigmatizing Beliefs
• Self-stigmatization
“…participants described feeling ‘weak’, ‘stupid’, ‘worthless’, ‘bad’, ‘ashamed’ and ‘embarrassed.”
→ Self-esteem
→ Self-efficacy
→ Perceived social worth
→ Health problems
→ Problem is kept secret
(Hing et al. 2014: 73-74, Hing et al. 2016a: 264)
7Email: [email protected]
Universität Hohenheim
Forschungsstelle Glücksspiel
Prof. Dr. Tilman Becker
Gambling Motivation
• Gambling as strategy to cope with problems and/or stress
• High stress level
– Multiple disorders/(psychic) comorbidities
– Quality of life (e. g. problematic childhood, traumas)
(Vogelgesang 2011: 117)
“Married female problem gamblers often have poor relationships.”
(Boughton 2003: 5)
→ “…women [feared] that treatment would ’require me to give up all gambling when I don't want to’” (Boughton 2003: 4)
8Email: [email protected]
Universität Hohenheim
Forschungsstelle Glücksspiel
Prof. Dr. Tilman Becker
Life Situation
9Email: [email protected]
Universität Hohenheim
Forschungsstelle Glücksspiel
Prof. Dr. Tilman Becker
Source: Deutsche Suchthilfestatistik 2014(German statistics of addiction aid)
Persons with main diagnosis pathological gambling (in %)
3,3
34,3
62,4
3,3
33,3
63,5
0 50 100
unknown
living alone
not living alone
females (n=1.344)
males (n=9.654)
8,6
7,7
29,4
30,2
55,7
6,1
5,9
9,2
48,7
59,4
0 10 20 30 40 50 60 70
other person(s)
other relative(s)
parent(s)
child(ren)
partner
females (n=853)males (n=6.028)
Perception of Treatment Programmes
• Do treatment programmes address andappeal to women and their needs?
→ Sensitive topics (e.g. experience ofviolence) need protected environment
→ Different age group
→ Child care
10Email: [email protected]
Universität Hohenheim
Forschungsstelle Glücksspiel
Prof. Dr. Tilman Becker
Factors Influencing Treatment Seeking
• Stigmatization (genderrole)
• Stress (comorbidities, biography, actual livingconditions)
• Appropriateness oftreatment services
11Email: [email protected]
Universität Hohenheim
Forschungsstelle Glücksspiel
Prof. Dr. Tilman Becker
Ingrid Ruthke / pixelio.de
List of Sources
Bellringer, M. et al. (2008). Problem gambling - barriers to help seeking behaviour, Final report, 1-188.
Boughton, R. (2003). A feminist slant on counselling the female gambler: Key issues and tasks. Electronic Journal of Gambling Issues 8, 1-23.
Hing, N. et al. (2016a). How does the stigma of problem gambling influence helpseeking, treatment and recovery? a view from the counselling sector, International Gambling Studies, 16:2, 263-280.
Hing, N. et al. (2016b). Perceived stigma and self-stigma of problem gambling: perspectives of people with gambling problems, International Gambling Studies, 16:1, 31-48.
Hing, N. et al. (2014). Stigma and problem gambling: current knowledge and future research directions. International Gambling Studies, 14:1, 64-81.
Holdsworth, L. et al. (2013): All Mixed Up Together: Women's Experiences of Problem Gambling, Comorbidity and Co-occurring Complex Needs. International Journal of Mental Health and Addiction, 11(3), 315-328.
Rodda, S. N. et al. (2014). Improved outcomes following contact with a gambling helpline: the impact of gender on barriers and facilitators. International Gambling Studies, 14:2, 318-329.
Slutske, W. S. (2006). Natural recovery and treatment-seeking in pathological gambling: Results of two U.S. national surveys. American Journal of Psychiatry, 163(2), 297-302.
Suurvali, H. et al. (2009). Barriers to Seeking Help for Gambling Problems: A Review of the Empirical Literature. Journal of Gambling Studies 25, 407-424.
Vogelgesang, M. (2011): Gender. In Petry, J. et al., Pathologisches Glücksspielen, Suchtmedizinische Reihe Band 6, 114-121.
12Email: [email protected]
Universität Hohenheim
Forschungsstelle Glücksspiel
Prof. Dr. Tilman Becker