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      Prevalence of gambling-related harm provides evidence for the prevention paradox

      1 , * , , 1
      Journal of Behavioral Addictions
      Akadémiai Kiadó
      gambling harm, prevention paradox, public health

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          Abstract

          Background

          The prevention paradox (PP) describes a situation in which a greater number of cases of a disease-state come from low-risk members of a population, because they are more prevalent than high-risk members. Past research has provided only tangential and disputed evidence to support the application of the PP to gambling-related harm.

          Aims

          To assess whether the PP applies to gambling, the prevalence of a large set (72) of diverse harmful consequences from gambling was examined across four risk categories for problem gambling, including no-risk, low-risk, moderate-risk, and problem-gambling.

          Methods

          Respondents who had gambled on non-lottery forms in the past 6 months completed an online survey ( N = 1,524, 49.4% male). The data were weighted to the known prevalence of gambling problems in the Victorian community.

          Results

          The prevalence of gambling harms, including severe harms, was generally higher in the combined categories of lower risk categories compared to the high-risk problem-gambling category. There were some notable exceptions, however, for some severe and rare harms. Nevertheless, the majority of harms in the 72-item list, including serious harms such as needing temporary accommodation, emergency welfare assistance, experiencing separation or end of a relationship, loss of a job, needing to sell personal items, and experiencing domestic violence from gambling, were more commonly associated with lower risk gamblers.

          Conclusion

          Many significant harms are concentrated outside the ranks of gamblers with a severe mental health condition, which supports a public-health approach to ameliorating gambling-related harm.

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          Most cited references24

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          Understanding gambling related harm: a proposed definition, conceptual framework, and taxonomy of harms

          Background Harm from gambling is known to impact individuals, families, and communities; and these harms are not restricted to people with a gambling disorder. Currently, there is no robust and inclusive internationally agreed upon definition of gambling harm. In addition, the current landscape of gambling policy and research uses inadequate proxy measures of harm, such as problem gambling symptomology, that contribute to a limited understanding of gambling harms. These issues impede efforts to address gambling from a public health perspective. Methods Data regarding harms from gambling was gathered using four separate methodologies, a literature review, focus groups and interviews with professionals involved in the support and treatment of gambling problems, interviews with people who gamble and their affected others, and an analysis of public forum posts for people experiencing problems with gambling and their affected others. The experience of harm related to gambling was examined to generate a conceptual framework. The catalogue of harms experienced were organised as a taxonomy. Results The current paper proposes a definition and conceptual framework of gambling related harm that captures the full breadth of harms that gambling can contribute to; as well as a taxonomy of harms to facilitate the development of more appropriate measures of harm. Conclusions Our aim is to create a dialogue that will lead to a more coherent interpretation of gambling harm across treatment providers, policy makers and researchers.
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            Gambling and related mental disorders: a public health analysis.

            This article reviews the prevalence of gambling and related mental disorders from a public health perspective. It traces the expansion of gambling in North America and the psychological, economic, and social consequences for the public's health, and then considers both the costs and benefits of gambling and the history of gambling prevalence research. A public health approach is applied to understanding the epidemiology of gambling-related problems. International prevalence rates are provided and the prevalence of mental disorders that often are comorbid with gambling problems is reviewed. Analysis includes an examination of groups vulnerable to gambling-related disorders and the methodological and conceptual matters that might influence epidemiological research and prevalence rates related to gambling. The major public health problems associated with gambling are considered and recommendations made for public health policy, practice, and research. The enduring value of a public health perspective is that it applies different 'lenses' for understanding gambling behaviour, analysing its benefits and costs, as well as identifying strategies for action. Harvey A. Skinner (160, p. 286)
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              Validity of the Problem Gambling Severity Index interpretive categories.

              The Problem Gambling Severity Index (PGSI) is a widely used nine item scale for measuring the severity of gambling problems in the general population. Of the four gambler types defined by the PGSI, non-problem, low-risk, moderate-risk and problem gamblers, only the latter category underwent any validity testing during the scale's development, despite the fact that over 95% of gamblers fall into one of the remaining three categories. Using Canadian population data on over 25,000 gamblers, we conducted a comprehensive validity and reliability analysis of the four PGSI gambler types. The temporal stability of PGSI subtype over a 14-month interval was modest but adequate (intraclass correlation coefficient = 0.63). There was strong evidence for the validity of the non-problem and problem gambler categories however the low-risk and moderate-risk categories showed poor discriminant validity using the existing scoring rules. The validity of these categories was improved with a simple modification to the scoring system.
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                Author and article information

                Journal
                jba
                2006
                Journal of Behavioral Addictions
                J Behav Addict
                Akadémiai Kiadó (Budapest )
                2062-5871
                2063-5303
                15 May 2018
                June 2018
                : 7
                : 2
                : 410-422
                Affiliations
                [ 1 ]School of Health, Medical and Applied Sciences, Central Queensland University , Branyan, QLD, Australia
                Author notes
                [* ]Corresponding author: Matthew Browne; School of Health, Medical and Applied Sciences, Central Queensland University, Bundaberg Campus, B8 G.47 University Drive, Branyan 4670, QLD, Australia; Phone: +61 7 4150 7002; E-mail: m.browne@ 123456cqu.edu.au
                Article
                10.1556/2006.7.2018.41
                330bf1ac-2f7f-462f-ba71-fff82528d341
                © 2018 The Author(s)

                This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium for non-commercial purposes, provided the original author and source are credited, a link to the CC License is provided, and changes – if any – are indicated.

                History
                : 11 December 2017
                : 22 March 2018
                : 07 April 2018
                : 08 April 2018
                Page count
                Figures: 10, Tables: 1, Equations: 0, References: 21, Pages: 13
                Funding
                Funding sources: Data collection for this study was funded by the Victorian Responsible Gambling Foundation (VRGF). MB has received funding from the NZ Ministry of Health, VRGF, the Queensland Department of Health, the Tasmanian Department of Treasury and Finance, the Alberta Gambling Research Institute, the First Nations Foundation and Gambling Research Australia. MJR has additionally received funding from the Department of Social Services (Federal), the Queensland Treasury, and the Victorian Department of Justice.
                Categories
                FULL-LENGTH REPORT

                Evolutionary Biology,Medicine,Psychology,Educational research & Statistics,Social & Behavioral Sciences
                prevention paradox,public health,gambling harm

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