gambling-related problems in adolescence · dr. tobias hayer “gambling-related problems in...
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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“
… 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
“Gambling-related problems in adolescence“
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
“Gambling-related problems in adolescence“
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
“Gambling-related problems in adolescence“
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
“Gambling-related problems in adolescence“
Youth problem gambling – Evidence from North America
But why?
Dr. Tobias Hayer
“Gambling-related problems in adolescence“
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
“Gambling-related problems in adolescence“
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
“Gambling-related problems in adolescence“
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
“Gambling-related problems in adolescence“
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
“Gambling-related problems in adolescence“
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
“Gambling-related problems in adolescence“
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
“Gambling-related problems in adolescence“
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
“Gambling-related problems in adolescence“
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
“Gambling-related problems in adolescence“
Validation – Procedure (ongoing)
Online survey
(adolescents with gambling
experience)
n≈100
Overall sampling goal:
N≈1,000
Dr. Tobias Hayer
“Gambling-related problems in adolescence“
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
“Gambling-related problems in adolescence“
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
“Gambling-related problems in adolescence“
Validation – Online survey
http://ww2.unipark.de/uc/hayer/
Gambling definition
Gambling activities (including the fake item “Blizzo“)
Dr. Tobias Hayer
“Gambling-related problems in adolescence“
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