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The possible reasons why adolescent
problem gamblers don't seek treatment include the following:
- More adolescents deny they
have a gambling problem compared to adults, and therefore, fewer of
them seek treatment.
- Adolescents may acknowledge
they have a gambling problem but do not want to seek treatment.
- There are few or no treatment
programs available for adolescents.
- Available treatment programs
are not appropriate and/or suitable for adolescents.
- Adolescent problem gamblers
may undergo spontaneous remission and/or mature out of gambling problems,
and therefore, may not seek treatment.
- Adolescent problem gamblers
are constantly "bailed out" of trouble by their parents, and therefore,
do not get treatment.
- The negative consequences
of adolescent problem gambling are not necessarily unique to gambling
and may be attributed either consciously or unconsciously to other behaviours.
- Adolescent gamblers may
lie or distort the truth when they fill out survey questionnaires.
- Screening instruments for
assessing problematic gambling may not be valid for adolescents.
- Researchers may consciously
or unconsciously exaggerate the adolescent gambling problem to serve
their own careers.
All over the world, prevalence
surveys of adolescent gambling have shown that a small but significant
number of adolescents display signs of problematic gambling. Further to
this, surveys consistently show that the prevalence rates for problematic
gambling are higher in adolescents than in adults. Given this consistent
finding, it raises the interesting paradox of why so few adolescents enrol
for treatment programs compared with adults. This short paper speculates
and gives 10 reasons why this situation might exist. Each reason is examined
briefly in turn before conclusions are reached.
(1) More adolescents deny
they have a gambling problem compared to adults, and therefore, fewer
of them seek treatment
This proposition seems plausible,
but there is no direct empirical evidence to support such a claim. It
is well known that many adult gamblers continually deny they have any
kind of gambling problem, an observation that has also been noted in
adolescents (Griffiths, 1995). However, there is no evidence to indicate
or even suggest that adolescents experience denial at a higher rate
than adults do.
(2) Adolescents may acknowledge
they have a gambling problem but do not want to seek treatment
Again, this is plausible,
but there is little empirical evidence to support the claim. However,
it has been noted that families of adolescent problem gamblers are often
protective — if not overprotective — and try to keep the problem
within the family (Griffiths, 1995). Therefore, it may be speculated
that seeking formal help may be a last resort option for most adolescent
gamblers.
(3) There are few or no treatment
programs available for adolescents
It is true that specialized
treatment programs for problem gamblers have only really started to
emerge in noticeable numbers over the last 10 years, and that they have
been confined to a few countries (e.g., USA, Australia, Canada, Spain,
The Netherlands). Services specifically for adolescent problem gamblers
appear to be few and far between. It could be argued that this is a
"Catch 22" situation: If only a few adolescents turn up for treatment,
treatment programs won't be able to provide specialized service, and
adolescent problem gamblers cannot turn up for treatment if it does
not exist!
(4) Available treatment programs
are not appropriate and/or suitable for adolescents
To some extent, this explanation
is interlinked with number 3, but is, in fact, different. This explanation
points out that there are gambling treatment programs available, but
most of the programs are group-oriented (e.g., Gamblers Anonymous, hospital
treatment programs, etc.). Adolescents may not want to be integrated
into what they perceive to be an adult environment. For instance, there
is some evidence from the U.K. that shows that adolescents who turn
to Gamblers Anonymous feel they don't fit in and may be alienated by
the dominating presence of older males (Griffiths, 1995). Also in the
U.K., the majority of adolescent gambling problems concern slot machine
playing; however, adult problem gambling is more likely to consist of
horseracing and/or casino gambling. Adult problem gamblers, therefore,
find it hard to accept gambling problems outside of their own experience
and cannot understand why adolescents find slot machines to be problematic
(Griffiths, 1995).
(5) Adolescent problem gamblers
may undergo spontaneous remission and/or mature out of gambling problems,
and therefore, may not seek treatment
There are many accounts in
the literature of spontaneous remission of problematic behaviour (e.g.,
alcohol abuse, heroin abuse, cigarette smoking), and problematic gambling
is no exception. Because levels of problem gambling are much higher
in adolescents than in adults, and fewer adolescents receive treatment
for their gambling problem, it is reasonable to assume that spontaneous
remission occurs in most adolescents at some point, or that there is
some kind of "maturing out" process. There is a lot of case-study evidence
(Griffiths, 1995) highlighting the fact that spontaneous remission occurs
in problem adolescent gamblers, and that gambling often ceases because
of some kind of new major responsibility (job, marriage, birth of a
child, etc.).
(6) Adolescent problem gamblers
are constantly "bailed out" of trouble by their parents, and therefore,
do not get treatment
Unlike adult problem gamblers
who quite often take responsibility for themselves and their families,
adolescents have no "real" responsibilities and are usually housed,
fed, clothed and generally looked after. If adolescents get into trouble
because of their gambling, their families will mostly likely act as
a safety net and bail them out. It could be speculated that very few
adolescents reach treatment programs because they are constantly "bailed
out" by their parents or guardians. In addition, adolescents are typically
at a rebellious phase in their lives, and to some extent, society tolerates
these undesirable behaviours because in most cases the behaviour subsides
over time. The same kinds of behaviours in adults aren't usually tolerated,
and so they are treated differently by both family and society in general.
(7) The negative consequences
of adolescent problem gambling are not necessarily unique to gambling
and may be attributed either consciously or unconsciously to other behaviours
Some adolescents may attribute
their undesirable and/or criminal behaviours (e.g., stealing) to other
behaviours, such as alcohol abuse or illicit drugs. For instance, in
the U.K., some writings (Yeoman & Griffiths, 1996; Griffiths &
Sparrow, 1996) have noted that criminal behaviour attributed to a drug
problem is probably more likely to result in a lighter sentence than
if problematic gambling were the cause. It appears that problematic
gambling as a mitigating circumstance is of less importance to judges
and juries than, say, drug abuse.
(8) Adolescent gamblers may
lie or distort the truth when they fill out survey questionnaires
This is a reasonable enough
assumption to make and can be made against anyone who participates in
self-report research — not just adolescents. All researchers who
utilize self-report methods put as much faith as they can into their
data but are only too aware that other factors may come into play (e.g.,
social desirability, motivational distortion, etc.) that can either
underscore or overplay the situation. In these particular circumstances,
it may be that adolescents are more likely to lie than adults, therefore
increasing the prevalence rate of problematic gambling. However, it
seems unlikely that the large difference in prevalence rates would be
due to this factor alone.
(9) Screening instruments
for assessing problematic gambling may not be valid for adolescents
Although there are many debates
about the effectiveness of screening instruments (e.g., SOGS, DSM-III-R,
DSM-IV, GA Twenty Questions) for assessing problematic gambling, it
could be the case that many of these question-based screening instruments
are not applicable, appropriate and/or valid for assessing adolescent
problem gambling. Although there is now a validated junior version of
the DSM-IV (DSM-IV-J) (Fisher, 1993), most research assessing problematic
gambling in adolescents has used adult screening instruments. It may
be that there is little difference between adult and adolescent screening
instruments. If there is a difference, the results are most likely to
be under-reported as items asking about illegal behaviours, such as
fraud or embezzlement, are highly unlikely to be reported by adolescents.
(10) Researchers consciously
or unconsciously exaggerate the adolescent gambling problem to serve their
own careers
This explanation is somewhat
controversial but cannot be ruled out without at least examining the
possibility. If this explanation is examined on a logical and practical
level, it can be argued that those of us who have careers in the field
of problem gambling could potentially have a lot to lose if there were
no problems. Therefore, it could be argued that it is in the researcher's
interest for problems to be exaggerated. However, there is no empirical
evidence that this is the case, and all researchers are aware that their
findings will be rigorously scrutinized. It's not in their best long-term
interest to make unsubstantiated claims.
Concluding Comments
Although the list may not be
exhaustive, it does give the main speculative reasons why adolescent problem
gamblers may be under-reported in turning up for treatment. It is likely
that no single reason provides more of an explanation than another does.
However, there does not seem to be any empirical evidence for at least
three of the assertions made (i.e. adolescents denying having a gambling
problem, adolescents not wanting to seek treatment, and researchers exaggerating
the adolescent gambling problem to serve their own careers). However,
just because there is no empirical evidence does not mean that it is not
possible.
Of the reasons remaining, some
include those that are not unique to adolescents (e.g., invalid screening
instruments for measuring problem gambling, lying or distorting by participants
on self-report measures, denying having a gambling problem, and not wanting
to seek treatment). These may therefore be more unlikely reasons why adolescents
do not turn up for treatment compared to the reasons that seem to particularly
refer to adolescents only (i.e. spontaneous remission and/or maturing
out of adolescent gambling problems, adolescents being constantly "bailed
out" by parents, lack
of adolescent treatment programs, and inappropriateness of treatment programmes).
What is quite clear is that
there is no single assertion in this article that provides a definitive
answer to the adolescent gambling treatment paradox. It is most likely
the case that many of the plausible explanations interlink to produce
the obvious disparities between prevalence rates and enrolling in treatment
programs.
References
- Fisher, S. (1993).
- Gambling and pathological
gambling in adolescents. Journal of Gambling Studies, 9, 277–288.
- Griffiths, M.D. (1995).
- Adolescent Gambling.
London: Routledge.
- Griffiths, M.D. &
Sparrow, P. (1996).
- Funding fruit machine addiction:
The hidden crime. Probation
Journal, 43, 211–213.
- Yeoman, T. & Griffiths,
M.D. (1996).
- Adolescent machine gambling
and crime. Journal of Adolescence, 19, 183–188.
This article was not peer-reviewed.
Submitted: October 17,
2000
Accepted: May 5, 2001
Address for correspondence:
Mark Griffiths,
PhD
Psychology Division, Nottingham Trent University,
Burton Street, Nottingham, United Kingdom
NG1 4BU
Phone: +44 (0) 115 8485528
Fax: +44 (0) 115 8486826
E-mail: mark.griffiths@ntu.ac.uk
Mark Griffiths, PhD,
is a reader in Psychology at Nottingham Trent University and is internationally
known for his research on gambling and gaming addictions. In 1994 he
was the first recipient of the John Rosecrance Research Prize for "Outstanding
scholarly contributions to the field of gambling research." He has published
over 90 refereed research papers, numerous book chapters and over 250
other articles. His current interests are technological addictions,
especially computer games and the Internet.
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