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Ethnic & Gender Differences in Youth Problem Gambling. Lera Joyce Johnson, Ph.D. Centenary College of Louisiana James R. Westphal, M.D. Louisiana State University Health Science Center Shreveport LA

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ethnic gender differences in youth problem gambling

Ethnic & Gender Differences in Youth Problem Gambling

Lera Joyce Johnson, Ph.D.

Centenary College of Louisiana

James R. Westphal, M.D.

Louisiana State University Health Science Center

Shreveport LA

Paper presented at “Innovation 2001” Conference hosted by the Canadian Foundation on Compulsive Gambling, Toronto, Ontario, April 22-25, 2001

slide2

Gender Differences in Health Behaviors

  • Males have earlier and higher mortality rates
  • Males use substances (tobacco, alcohol, street drugs) more than females
  • Females use more health services, medications & mental health services than males
  • Males have more substance use disorders except for prescribed medications
  • Females have more psychiatric disorders especially in the anxiety/depression cluster.
  • Males have traditionally outnumbered females in gambling disorders by a 6 to 1 margin.

Johnson & Westphal 2001

early identification of problem gamblers among adolescents
Early Identification of Problem Gamblers Among Adolescents
  • Adults with gambling problems typically show early onset of gambling activities
  • Early identification of potential problem gambling indicators during adolescence could foster timely interventions
  • There are minimal studies on the interaction of gender and ethnicity in adolescent gamblers

Johnson & Westphal 2001

early indicators among adults with gambling problems
Early Indicators Among Adults with Gambling Problems
  • Robins & Przybeck (1985) conducted a large scale study of adults in New Haven, Baltimore & St. Louis. They found that if drug use began before the age of 15, the user was at greater risk for a drug disorder, & that drug disorders were associated with other psychiatric disorders. Subsequently, research attention has been directed at adolescents.
  • Research has shown that many adult pathological gamblers began their careers during adolescence (Ladouceur, 1991; Ide-Smith & Lea, 1988; Ladouceur & Mirault, 1988; Lesieur & Klein, 1987; Custer, 1982; Dell, Ruzika, & Palisi, 1981).

Johnson & Westphal 2001

risks for problem gambling among minorities
Risks for Problem Gambling Among Minorities
  • Risks for addictive behaviors are disproportionately high among Native American (Elia & Jacobs, 1993; Jacobs, 1991) & African Americans (Jacobs, 1991).
  • Comparisons showed significantly higher gambling problems among Native Americans than non-Indian adults in a Northern Plains reservation ( Zitzow, 1996).
  • A study of close to 3,000 adolescents in 7th, 9th, & 11th grades in Ventura California found that Native American youths were exposed to more risk factors leading to substance abuse than were Asians, Blacks, Hispanics or Whites (Newcomb et al., 1987).

Johnson & Westphal 2001

gender differences in problem gambling
Gender Differences In Problem Gambling
  • The literature on gender differences in gambling is relatively sparse& focused on adults.
  • Women tend to gamble at fewer types of gambling activities than men (Volberg & Banks, 1984).
  • Adult women tend to gamble at legalized gambling activities such as bingo, while males tend to play lotteries, casino games, sports betting, and stock/commodities speculation (Downes, 1976; Kallick, Suits, Dielman, & Hybels, 1979; Lundgren et al., 1987)
  • Prevalence rates of women with gambling problems are increasing (Volberg, 1999; Johnson, Nora, & Bustos, 1992; McAleavy, 1995)

Johnson & Westphal 2001

gender differences in gambling problems treatment
Gender Differences in Gambling Problems & Treatment
  • Crisp et al. (2000) noted that:
  • Females make up the majority of clients for health service agencies (Australian Inst. Of Health & Welfare, 1996; Cokerham, 1997) & are more than 2X as likely as males to seek treatment in their lifetime (Collier, 1982)
  • More males are in treatment for problem gambling (Ciarrocchi & Richardson 1989; Taber, McCormick, Russo, Adkins, & Ramirez, 1987) with 86% to 93% male clients in TX in 5 American states (Volberg, 1994), even though females are just as likely as males to experience problem gambling (Hraba & Lee, 1996; Ohtsuka, Bruton, DeLuca, & Borg, 1997), and many women may need help (Reed, 1985)

Johnson & Westphal 2001

females with disordered gambling
Females with Disordered Gambling
  • Females who do seek tx for gambling problems present a different profile than males. Females are:
    • more likely to have been victims of child abuse
    • more likely to have attempted suicide
    • more likely to have a mother who has a compulsive gambling problem
    • less likely to have been arrested(Ciarrocchi & Richardson, 1989).
    • less likely to be screened for gambling problems (Downing, 1991; Mark & Lesieur, 1992)

Johnson & Westphal 2001

slide9

Westphal, Johnson, & Stephens, 2000

Gender Differences in Gambling Career

  • Females reported significantly (p < .05) shorter gambling careers 4.34 years vs. 8.3 years for males
  • Females reported significantly (p < .01) later onset of gambling (males=23.2; females = 31.4 yrs), later onset of weekly gambling (males = 29; females 37 yrs) (p < .01) & later onset of problem gambling (p < .05) (males = 32.5; females = 39.4 yrs).
  • No significant differences in gambling behavior (mostly casino and video poker).

Johnson & Westphal 2001

male model may not generalize to females with gambling problems
Male Model May Not Generalize to Females with Gambling Problems
  • When women enter gambling treatment programs that are designed for the male prototype, staff may not be able to deal with gender-specific problems (Reed, 1985)
  • Tx programs may fit males better b/c of research on all-male samples (Brown, 1986, 1987a,b,c), use of all-male controls (Zimmerman, Meeland, & Krug, 1985), or lack of gender analyses(Mark & Lesieur, 1992)

Johnson & Westphal 2001

gender differences in gambling tx
Gender Differences in Gambling Tx
  • Crisp et al. (2000) studied 1520 cases (half male, half female) in Victoria, Australia;
  • Differences in presenting symptoms:
    • males report employment & legal matters
    • females report problems with physical & intrapersonal functioning
  • Differences in treatment outcomes:
    • males more likely to have cases closed & be referred to other agencies
    • females more likely to report resolution

Johnson & Westphal 2001

methodological foundations
Methodological Foundations
  • Gambling research has been both “gender insensitive” & overgeneralized (Eichler, 1986; c.f., Delfabbro, 2000). Findings from male-only studies may not form a sufficient basis for intervention strategies (Crisp, 1998)
  • Gender differences may reflect traditional gender roles, different motivations for participation, sex-role socialization, & cultural factors (Delfabbro, 2000) as well as which gaming activities are being compared
  • Robins & Przybeck (1985) found gender differences (males > females for drug disorders) & ethnic differences ( Blacks > ‘Whites & Other’ drug disorders), but did notanalyze ethnicity and gender together.

Johnson & Westphal 2001

objectives
Objectives
  • 1. Derive a frequency index for games played by adolescents in Louisiana on a daily or weekly basis
  • 2. Calculate the estimated prevalence of pathological gambling among students with DSM-IV J criteria
  • 3. Regress on pathological classification with ethnicity & gender, separately & together

Johnson & Westphal 2001

method
Method
  • Survey of gambling behavior including DSM IV-J criteria was administered to randomized stratified sample of grades 6-12 in 57/64 parishes, public & private schools N=11,736 & criminal justice population including:
    • 343 jail
    • 1293 prison
    • all juvenile offenders were ages 10 to 19

Johnson & Westphal 2001

demographics for criminal justice sample
Demographics for Criminal Justice Sample
  • (N=1636)
  • predominantly male (88.3%)
  • majority black (73.7%; Caucasian 13.4%; 4.5% Native American; 7.9% other or missing)
  • Age distribution: 9.2% 13 or under; 13.4% age 14; 22.4% age 15; 28.9% age 16; 16.8% age 17; 9.4% age 18 or older

Johnson & Westphal 2001

results objective 1 frequency of participation
Results Objective 1: Frequency of Participation
  • School & justice samples were pooled for analyses
  • Frequency of participation in licensed & unlicensed games were observed
    • Overall
    • By Gender only
    • By Ethnicity only

Johnson & Westphal 2001

comparison of frequent play at licensed games by gender
Comparison of Frequent Play at Licensed Games by Gender

***All differences significant to .001.

Johnson & Westphal 2001

comparison of frequent play at unlicensed games by gender
Comparison of Frequent Play at Unlicensed Games by Gender

*

***All differences significant to .001.

Johnson & Westphal 2001

comparison of frequency at licensed games by ethnicity
Comparison of Frequency at Licensed Games by Ethnicity

*** All differences significant to .001 except **Lotto at .01

Johnson & Westphal 2001

comparison of frequency at unlicensed games by ethnicity
Comparison of Frequency at Unlicensed Games by Ethnicity

***All differences significant to .001

Johnson & Westphal 2001

results objective 2 estimate prevalence of pathological gambling
Results: Objective 2 Estimate Prevalence of Pathological Gambling
  • Pathological estimates based on DSM IV-J
  • Observed by Gender only
  • Observed by Ethnicity only
  • Observed by Gender and Ethnicity

Johnson & Westphal 2001

pathology among adolescents
Pathology Among Adolescents

Johnson & Westphal 2001

gender within pathology
Gender within Pathology

*** All differences significant to .001.

Johnson & Westphal 2001

ethnicity within pathology
Ethnicity within Pathology

*** All differences significant to .001.

Johnson & Westphal 2001

gender ethnicity within pathology
Gender & Ethnicity Within Pathology

***

**

Johnson & Westphal 2001

frequency ethnicity gender
Frequency, Ethnicity & Gender
  • School & justice samples of adolescents were pooled
  • Categorical regressions were performed on estimated pathological classification (using DSM IV-J) on each game with frequency of play, ethnicity, & gender as predictors
  • Some sub-groups showed more frequent participation, yet frequency alone was not a significant predictor of pathology apart from gender & ethnicity

Johnson & Westphal 2001

layout
Layout

Johnson & Westphal 2001

slide28

Adolescents

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slide29

Males

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slide30

Females

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slide31

African American

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slide32

Caucasian

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slide33

Native American

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slide34

African American Males

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slide35

African American Females

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slide36

Caucasian Males

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slide37

Caucasian Females

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slide38

Native American Males

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slide39

Native American Females

Johnson & Westphal 2001

cards prevalence of frequent play alone does not predict pathology
Cards: Prevalence of Frequent Play Alone Does Not Predict Pathology***

Predicted Pathology

Frequent play at cards was not predictive for Native American females

Johnson & Westphal 2001

slide41
Horse/Dog Races: Prevalence of Frequent Play Alone Does Not Predict Pathology***Significant to .001 AfrAmer & Cauc; NS for NatAmer

Predicted

Pathology

Johnson & Westphal 2001

dice prevalence of frequent play alone does not predict pathology
Dice: Prevalence of Frequent Play Alone Does Not Predict Pathology***

Predicted

Pathology

Johnson & Westphal 2001

slide43
Riverboat Casinos: Prevalence of Frequent Play Alone Does Not Predict Pathology***Significant to .001 AfrAmer & Cauc; * .05 NatAmer

Predicted

Pathology

.057

Johnson & Westphal 2001

slots prevalence of frequent play alone does not predict pathology
Slots: Prevalence of Frequent Play Alone Does Not Predict Pathology***

Predicted

Pathology

Johnson & Westphal 2001

bingo prevalence of frequent play alone does not predict pathology
Bingo: Prevalence of Frequent Play Alone Does Not Predict Pathology***

Predicted

Pathology

Johnson & Westphal 2001

betting on sports teams prevalence of frequent play alone does not predict pathology
Betting on Sports Teams: Prevalence of Frequent Play Alone Does Not Predict Pathology***

Predicted

Pathology

Johnson & Westphal 2001

slide47
Scratch Lottery: Prevalence of Frequent Play Alone Does Not Predict PathologyNS for Males; Significant to .001 Females

Predicted

Pathology

Johnson & Westphal 2001

video poker prevalence of frequent play alone does not predict pathology
Video Poker: Prevalence of Frequent Play Alone Does Not Predict Pathology***

Predicted

Pathology

Johnson & Westphal 2001

lotto prevalence of frequent play alone does not predict pathology ns for males 01 for females
Lotto: Prevalence of Frequent Play Alone Does Not Predict PathologyNS for Males; *.01 for Females

Predicted

Pathology

Johnson & Westphal 2001

coins prevalence of frequent play alone does not predict pathology
Coins: Prevalence of Frequent Play Alone Does Not Predict Pathology***

Predicted

Pathology

Johnson & Westphal 2001

conclusions
Conclusions
  • Gender & ethnicity, when analyzed together, present a different profile for each subgroup than when pathology is predicted without gender or ethnicity, or when predicted by ethnicity or gender alone
  • Frequency of play in any of the gambling activities tested ALONE did not predict pathology among adolescents as well as when ethnicity and gender were included in the analysis; that is, frequency can only be judged when you know the pattern of play among genders within ethnic subgroups

Johnson & Westphal 2001