John W. Welte

Gambling Participation in the U.S.—Results from a National Survey

Demographic patterns of gambling participation in the U.S. were examined. A national telephone survey was conducted with 2,630 representative U.S. residents aged 18 or older. The sample as weighted for analysis was 48% male, 12% black, and 11% Hispanic. Respondents were questioned on 15 types of gambling: how often they played and how much they won or lost. Eighty-two percent gambled in the past year. Lottery was the most commonly played game, while casino gambling accounted for the largest extent of gambling involvement. Men and women were equally likely to gamble in the past year, but men gambled more frequently and had larger wins and losses, particularly on sports betting and games of skill. Blacks were less likely to have gambled in the past year, but blacks who gambled did so more heavily than other racial groups. Blacks and Hispanics were more likely than average to be pathological gamblers. The rate of past year gambling declined with age, but extent of gambling involvement among gamblers did not vary with age. Rates of participation in most forms of gambling increased with socioeconomic status, but higher socioeconomic status gamblers had lower rates of pathological gambling, and lower extent of gambling involvement, particularly for lottery. New Englanders gambled more heavily than other Americans. Comparison with past studies showed an increase in overall gambling participation in the U.S., and large increases in rates of participation in lottery and casino gambling.

The prevalence of problem gambling among U.S. adolescents and young adults: Results from a national survey

A random telephone survey was conducted with a representative sample of 2,274 U.S. residents aged 14–21. The prevalence of problem gambling, as measured by the SOGS-RA, was 2.1%. Sixty-eight percent (68%) of the respondents had gambled in the past year, and 11% had gambled more often than twice per week. Males had much higher gambling involvement than females, and gambling involvement increased among older respondents. Blacks were less likely than average to have gambled in the past year, but if they gambled, they were more likely to do so frequently. Low SES respondents were less likely to have gambled in the past year, but if they gambled, they were more likely to be problem gamblers. Life transitions that are associated with assuming adult roles (employment, living independently of parents, non-student status) are also associated with greater gambling involvement. The rates of problem and pathological gambling were lower than those in an adult survey conducted earlier, when measured with the same questionnaire.

Shared predictors of youthful gambling, substance use, and delinquency

Given that gambling, alcohol misuse, other drug use, and delinquency are correlated, it is hypothesized that these problem behaviors have shared antecedents. Measures from 3 explanatory domains--sociodemographic factors (age, race, and socioeconomic status), individual factors (impulsivity and moral disengagement), and socialization factors (parental monitoring and peer delinquency)--were tested for links to problem behaviors in 2 longitudinal samples of adolescents. Black youth had lower levels of problem behaviors than Whites. Impulsivity was a significant predictor of alcohol misuse for females and delinquency for males. Moral disengagement predicted gambling for males. Parental monitoring showed a significant inverse relationship to alcohol misuse and other substance use for males. Peer delinquency showed numerous prospective paths to youth problem behaviors for both genders.

The Relationship of Ecological and Geographic Factors to Gambling Behavior and Pathology

The current study examined the effect of neighborhood disadvantage and gambling availability on gambling participation and pathology. A national telephone survey included 2631 US adults. Census data was used to characterize the respondent’s neighborhood, and the distance from the respondent’s home to gambling facilities was calculated. Logistic and linear regressions were performed to predict gambling participation and pathology. Results showed that the neighborhood disadvantage was positively related to frequency of gambling and problem/pathological gambling. The presence of a casino within 10 miles of the respondent’s home was positively related to problem/pathological gambling. The permissiveness of gambling laws was positively related to any gambling in the past year, as well as frequent gambling. These results were interpreted to mean that the ecology of disadvantaged neighborhoods promotes gambling pathology, and that availability of gambling opportunities promotes gambling participation and pathology.

Relationship of Alcohol Use to Delinquency and Illicit Drug Use in Adolescents: Gender, Age, and Racial/Ethnic Differences

Alcohol use has been linked to other substance use and delinquency in adolescents. However, few studies have examined variations in these relationships in representative subsamples of gender, age and racial/ethnic groups. Respondents in this study were 19,321 New York State 7–12th grade students. After controlling for significant sociodemographic factors in a regression analysis, all of the alcohol measures remained strong predictors of both delinquency and illicit drug use. Significant interactions between alcohol measures and gender, age and racial/ethnic groups were also found. For example, the relationship between binge drinking and delinquency was stronger for males than females. The relationships between alcohol measures and both delinquency and illicit drug use were stronger for younger adolescents than older adolescents. American Indians showed an added risk over other groups of being delinquent and using illicit drugs if they began drinking at an early age. Prevention efforts to delay initiation into alcohol use are likely to have effects not only on alcohol misuse but also on the development of other substance use and delinquency.

Gambling and alcohol use among youth: influences of demographic, socialization, and individual factors

Gambling and alcohol use are both prevalent among youth and these behaviors may have common predictors within four domains: sociodemographic, individual/psychological, socialization (parental and peer), and other problem behavior. Data were from two household samples of youth in the Buffalo, NY area. Both studies included the same measures of alcohol consumption and gambling frequency, and comparable measures of variables in the four domains. Multivariate analyses of variance revealed that impulsivity, moral disengagement, and delinquency (adolescent or peer delinquency) predicted alcohol consumption and gambling in both studies, even after controlling for demographic factors. Parental monitoring, cigarette use, and illicit drug use predicted alcohol consumption in both studies, but did not predict gambling once the demographic and individual factors were taken into account.

Alcohol: The Gateway to Other Drug Use Among Secondary-School Students.

The “stepping-stone” theory of progression into drug use is examined, based on the alcohol and other drug use of over 27,000 seventh-through eighth-grade students in New York State. The data show that students do not use illicit drugs unless they also use alcohol. White, black and Hispanic students all tend to initiate the use of drugs in the following order-alcohol, marijuana, pills, and “hard” drugs. Among blacks and Hispanics, pills are not as important a transition between marijuana and hard drugs as they are among whites. Cigarettes form an important step between alcohol and marijuana use for younger students, particularly for females. Since alcohol serves as the gateway to all other drug use, prevention approaches that control and limit alcohol use among adolescents may be warranted.

Adolescent Alcohol Abuse: Subgroup Differences and Relationships to Other Problem Behaviors

Alcohol is the most widely used-and abused-drug by American youth. Because of the prevalence of youthful alcohol abuse, there is increasing public attention toward developing alcohol-specific prevention and treatment programs for adolescents. However, studies also show that youthful alcohol abuse is associated with a variety of other adolescent problem behaviors, such as illicit drug use and delinquency. These associations have provided empirical support for what Jessor and associates have conceptualized as problem behavior theory. In this information, alcohol abuse is viewed as one aspect of a psychosocial proneness toward engaging in problem behavior; or stated more succinctly, adolescent problem drinking is part of a problem behavior syndrome. The present study will determine the prevalence and correlates of alcohol abuse using a very large representative sample of secondary school students in New York State. The relationships between alcohol-related problems and other problem behaviors will be examined in the context of adolescent problem behavior theory. In addition, the extent of alcohol problems and the relationships between alcohol abuse and other problem behaviors may be different in minority groups than among the majority population of youth. These issues have not been adequately studied since most surveys of adolescent drinking have not included large numbers of Black, Hispanic, and other minority youth. However, service providers and program planners indicate a great concern about alcohol abuse among these special youthful populations. The ethnic diversity of New York State and this large sample of over 27,000 students permit an examination of alcohol abuse among specific adolescent minority groups.

Computerized Adaptive Assessment of Personality Disorder: Introducing the CAT-PD Project

Assessment of personality disorders (PD) has been hindered by reliance on the problematic categorical model embodied in the most recent Diagnostic and Statistical Model of Mental Disorders (DSM), lack of consensus among alternative dimensional models, and inefficient measurement methods. This article describes the rationale for and early results from a multiyear study funded by the National Institute of Mental Health that was designed to develop an integrative and comprehensive model and efficient measure of PD trait dimensions. To accomplish these goals, we are in the midst of a 5-phase project to develop and validate the model and measure. The results of Phase 1 of the project—which was focused on developing the PD traits to be assessed and the initial item pool—resulted in a candidate list of 59 PD traits and an initial item pool of 2,589 items. Data collection and structural analyses in community and patient samples will inform the ultimate structure of the measure, and computerized adaptive testing will permit efficient measurement of the resultant traits. The resultant Computerized Adaptive Test of Personality Disorder (CAT–PD) will be well positioned as a measure of the proposed DSM–5 PD traits. Implications for both applied and basic personality research are discussed.

Detection by the CAGE of alcoholism or heavy drinking in primary care outpatients and the general population.

There is a need to improve the diagnosis of alcoholism in clinical settings because alcoholism, particularly in its early stages, is often unrecognized in general medical practice and in hospitals. In this study the CAGE questionnaire was used to detect alcoholism or heavy drinking in three populations, namely, alcoholics in treatment (ALC), primary-care outpatients (PC), and the general population (GP). Nearly all the ALC tested positive on the CAGE (97.8%), both for current (past year) and for lifetime alcohol-related problems. Among the PC subjects, 44.8% tested positive for lifetime alcohol problems, but the prevalence decreased to 17.2% when only past-year problems were considered. Likewise, 38.3% of the GP sample tested positive for lifetime, but half of these did not meet the 1-year recency criterion. Compared to DSM-III-R criteria during the same time intervals, the sensitivity/specificity of the lifetime CAGE was 91.2%/84.0% and 76.9%/85.1% in the PC and GP, respectively. The corresponding sensitivity/specificity of the past-year CAGE was 94.4%/97.0% and 74.6%/91.6%, respectively. Thus, the CAGE is an appropriate screening test for alcohol problems in these two populations, but other confirmatory tests or interviews are necessary to eliminate false positives. There were neither gender nor racial differences in the ALC sample responses to individual CAGE questions. However, there were gender differences in the PC and GP samples, with more males responding yes to each of the questions. The gender differences probably reflected the higher prevalence of heavy drinking and alcoholism among males.