The Prevalence of Pathological Scratchcard Gambling Among Adult Scratchcard Buyers In
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UvA-DARE (Digital Academic Repository) Are scratchcards addictive? : two-year cumulative incidence and stability of pathological scratchcard gambling among Dutch scratchcard buyers de Fuentes Merillas, L. Publication date 2005 Link to publication Citation for published version (APA): de Fuentes Merillas, L. (2005). Are scratchcards addictive? : two-year cumulative incidence and stability of pathological scratchcard gambling among Dutch scratchcard buyers. General rights It is not permitted to download or to forward/distribute the text or part of it without the consent of the author(s) and/or copyright holder(s), other than for strictly personal, individual use, unless the work is under an open content license (like Creative Commons). Disclaimer/Complaints regulations If you believe that digital publication of certain material infringes any of your rights or (privacy) interests, please let the Library know, stating your reasons. In case of a legitimate complaint, the Library will make the material inaccessible and/or remove it from the website. Please Ask the Library: https://uba.uva.nl/en/contact, or a letter to: Library of the University of Amsterdam, Secretariat, Singel 425, 1012 WP Amsterdam, The Netherlands. You will be contacted as soon as possible. UvA-DARE is a service provided by the library of the University of Amsterdam (https://dare.uva.nl) Download date:30 Sep 2021 Chapterr 2 CHAPTERR 2 AREE SCRATCHCARDS ADDICTIVE? THE PREVALENCE OF PATHOLOGICALL SCRATCHCARD GAMBLING AMONG ADULT SCRATCHCARDD BUYERS IN THE NETHERLANDS1 ABSTRACT T AimsAims To determine the prevalence of regular, potential problematic, and pathological scratchcardscratchcard gambling (PSG) five years after the introduction of scratchcards in the Netherlands. Netherlands. DesignDesign and Participants A non-proportional stratified random sample of 12,222 scratchcard buyersbuyers was approached. Regular scratchcard buyers (N = 3,342) were asked to fill out the SouthSouth Oaks Gambling Screen (SOGS). Those with a SOGS score of 3 or more (N = 340) were interviewedinterviewed with the gambling section of the DSM-IV Diagnostic Interview Schedule (DIS-T). WeightedWeighted data were used to get unbiased prevalence estimates. FindingsFindings The estimated prevalence of regular and potential problematic scratchcard gamblinggambling were 28.4% and 2.68% respectively. Only 0.24% met DSM-IV criteria for PSG. Of those,those, only 0.09% was uniquely addicted to scratchcards. The remaining 0.15% was also addictedaddicted to other games of chance. Demographic and gambling characteristics of these "combined""combined" PSG (young men, mainly slot machines players) resembled characteristics of pathologicalpathological gamblers in general. In contrast to these 'combined' PSG, 'unique' PSG were mainlymainly women between 25 and 34 years who spent relatively small amounts of money on scratchcardsscratchcards (equivalent to one scratchcard a day). ConclusionConclusion Scratchcards have a very low addiction potential among adults in the Netherlands.Netherlands. Given the specific characteristics of the unique PSG and the relatively small amountamount of money they spent, the appropriateness of DSM criteria for this particular form of gamblinggambling can be questioned. INTRODUCTION N Thiss report describes one of the largest studies in the world regarding the prevalence of problematicc and pathological scratchcard gambling (PSG) among adult scratchcard buyers. So far,, this relatively new game of chance has been introduced in more than 40 countries, among whichh are the USA, Canada, Great Britain, Germany, Australia and China. After a long and oftenn heated public debate about their potential negative side-effects in terms of excessive playing,, scratchcards were introduced in the Netherlands in 1994. Since the 1950s several authorss have noted that the structural characteristics of different games are related to their addictivee potential (Royal Commission on Gambling, 1951; Griffiths, 1995). Based on these structurall characteristics, the addictive potential of scratchcards is generally considered to be 11 This chapter has been published as DcFuentes-Merillas, L., Koeter, M. W. J., Schippers, G. M., & Brink, W. vann den (2003) Are scratchcards addictive? The prevalence of pathological scratchcard gambling among adult scratchcardd buyers in the Netherlands. Addiction, 98, 725-731. 31 1 Aree scratchcards addictive? moderate,, i.e. higher than the risk of standard lotteries but lower than the risk of slot or fruit machiness and casino games. The most important characteristics that may actually facilitate excessivee gambling with scratchcards are: (1) "short-payout intervals" referring to the short periodd of time between the stake and the outcome; (2) "low threshold" in terms of accessibilityy and costs; and (3) the psychological effect of the "near miss", i.e. the occurrence off failures that are close to being successful, encouraging future play. As consequence of thesee and other similarities with fruit machines, scratchcards have been referred to as "paper fruitfruit machines" (Griffiths, 2000). Empiricall evidence of the "addiction potential" of instant lotteries, however, is scarce. Hendrikss et al. (1997) found among a sample of Dutch scratchcards buyers, that 4.1% were classifiedd as "at-risk players" who bought at least 25 scratchcards in the previous month and mett at least one at-risk or problem indicator. This study was conducted within a year of the introductionn of the scratchcards in the Netherlands, and therefore, no conclusions could be drawnn with regard to the risk of actual development of PSG, because it takes on average about 3.55 years before excessive gambling is recognised as a problem by the gambler himself or his sociall environment (Meyer, 1992). Severall British studies suggest a potential addiction risk of scratchcards. In a adult populationn sample, Shepherd, Ghodse & London (1998) found that the number of DSM-IV criteriaa met (but not the number of pathological gambling diagnoses) had increased 6 months afterr the introduction of the National Lottery Instants. In a study among 11-15-year-old adolescents,, 6% of the scratchcards players were diagnosed as pathological gamblers accordingg to DSM-IV-J criteria (Wood & Griffiths, 1998). In another study among 11-16- year-oldd boys, 5% of the total sample and 12% of the gamblers (who had bought scratchcards themselves)) met DSM-IV criteria for PSG (Griffiths, 2000). However, in Britain the sale of scratchcardss to persons under the age of 16 is forbidden, and therefore the latter two studies aree likely to address specific subgroups with specific psychological characteristics and life- styles,, which make the generalisation of these findings to a general adult population rather problematic. Inn summary, the addictive potential of scratchcard gambling is still unknown. In order too obtain a valid estimate of the addictive potential of scratchcard gambling a large epidemiologicall study is needed. The current study attempts to establish the prevalence of regular,, potential problematic and PSG among a representative sample of adult scratchcard buyerss 5 years after their introduction in the Netherlands using standardised assessments procedures. METHODS S Casee definition and assessment instruments Regularr scratchcard gamblers were defined as people who bought their first scratchcard more thann 6 months ago and who purchased of 10 or more scratchcards in the month prior to the assessment.. Two simple questions were used to obtain this information. Regular scratchcard 32 2 Chapterr 2 gamblerss were defined as potential problematic scratchcard gamblers if they had a score of threee or more on an adapted Dutch version of the South Oaks Gambling Screen (SOGS, Lesieurr & Blume, 1987). The original SOGS was adapted for this study through the replacementt of the word "gambling" by "scratchcard gambling" and through the refining of thee questions regarding the loss of control by exclusion of an impulsive purchase as an indicatorr of problematic gambling. The cut-off score of three was chosen to maximise sensitivityy and to ininimise the number of false negatives. Potential problematic scratchcard gamblerss were defined as pathological scratchcard gamblers if they met the adapted criteria of aa DSM-IY diagnosis pathological gambling, i.e. presence of at least five of the defining criteriaa during the year prior to the assessment. An adapted version of the Pathological Gamblingg Section of the DSM-IV Diagnostic Interview Schedule (DIS-T, Diagnostic and Statisticall Manual of Mental Disorders, 1994) was used with separate questions on each item regardingg scratchcard gambling and other games of chance excluding scratchcards and with onsett and recency questions for each individual item. An example of this adaptation is: "has yourr scratchcard gambling ever caused you trouble with your partner or a family member?", andd "has your gambling on other games of chance excluding scratchcards ever caused you troublee with your partner, or a family member?", instead of the original question "has your gamblinggambling ever caused you trouble with your partner or a family member?" In order to exclude thee presence of a manic episode, a mania screener was developed based on Section F of the DSM-IVV Diagnostic Interview Schedule (DIS-F, APA, 1994). Sample e AA non-proportional stratified sample was approached according to the following three steps. Inn the first step, a random sample of 246 out of the 2,285 sales outlets