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A recent systematic review of the responsible gambling research suggests that there are no significant differences between gambling industry and non-industry funded research with regard to research design and outcomes. This study empirically synthesizes the outcomes of a larger sample of the scientific gambling literature to determine the generalizability of these original results. Our goal was to determine the extent to which funding sources might differentially influence characteristics of research design and outcomes. We conducted a comprehensive review of 18 research databases and examined studies published between January 2008 and August 2018. For four gambling-related journals, we reviewed all of the available studies. For 14 addiction-related journals, we examined only studies that examined gambling-related outcomes. To be included in this study, publications had to be quantitative and include a clear gambling-related hypothesis. After retrieving 1731 gambling studies, we applied the inclusion criteria and retained 720 studies for our final analytic sample. We used hypothesis confirmation and funding source information to determine the presence or absence of funding bias. Gambling industry funded studies were no more likely than studies not funded by the gambling industry to report either confirmed, partially confirmed, or rejected hypotheses. Nonetheless, studies funded by the gambling industry were more likely than other types of funding sources to include a conflict of interest statement. Studies with disclosed funding sources were more likely than those with undisclosed funding sources to include a conflict of interest statement. These findings highlight the importance of transparency and disclosure during research dissemination. [ABSTRACT FROM AUTHOR]

Driving under the influence of alcohol or other substances is a serious public health concern. Previous research has shown that psychiatric comorbidity is more prevalent for repeat offenders than the general population, and that first-time offenders exhibit elevated rates of psychiatric comorbidity, but few studies have directly compared first-time and repeat DUI offenders. The current study compares psychiatric comorbidity among repeat and first-time DUI offenders. First-time and repeat DUI offenders completed the screener module of the Computerized Assessment and Referral System (CARS), adapted from the Composite International Diagnostic Interview (CIDI: Kessler & Ustun, 2004), to measure potential psychiatric comorbidity. For 16 of 19 psychiatric disorders, repeat DUI offenders were more likely to screen positive during their lifetime compared with first-time DUI offenders. Similarly, repeat DUI offenders were more likely to screen positive during the past year for 11 of 16 assessed psychiatric disorders. Overall, repeat DUI offenders screened positive for an average of 6.3 disorders during their lifetime, compared to first-time offenders who screened positive for an average of 3.7 disorders. Repeat DUI offenders also screened positive for more past-year disorders (M = 3.3) than first-time offenders (M = 1.9). Compared to first-time offenders, repeat DUI offenders evidence more severe and pervasive psychiatric comorbidity. Further research is necessary to determine whether psychiatric comorbidity among first-time offenders directly predicts re-offense. If so, screening for mental health issues among first-offenders could provide valuable information about how best to allocate resources for these offenders. • This study compares psychiatric comorbidity in first-time and repeat DUI offenders. • Repeat DUI offenders were more likely to screen positive for 16 of 19 disorders. • Repeat DUI offenders were more likely to experience symptoms of multiple disorders. • First-time DUI offenders also experienced extensive psychiatric problems. • Number of positive screens was more predictive of repeat DUI than specific screens. [ABSTRACT FROM AUTHOR]

This brief report examines whether there are differences in aspects of different characteristics, including design/methodologies of responsible gambling (RG), between studies funded by industry as compared to other sources. To investigate this, the authors used those studies included in a recent meta-analysis focusing on the empirical basis of RG initiatives (Ladouceur et al. in Addict Res Theory 25:225-235, 2017). We examined eight associations between funding sources, and different design/methodological characteristics of these studies; type of strategy, inclusion of comparison groups, measurement scales and repeated measures, publication source, number of inclusion criteria met, secondary sources of funding, publication year. The results revealed no statistically significant difference between the funding source, and the index study characteristics. These results do not support claims that funding exerts influence on the design or methodologies of RG studies. However, the absence of statistically significant findings should not be used to assert the absence of a funding effect because there are many reasons for failing to find differences, or interpretation of findings. Unexpectedly, a third of the papers included in this study failed to disclose their funding sources. This finding highlights the need for more open and transparent disclosures. [ABSTRACT FROM AUTHOR]

Daily fantasy sports (DFS), a rapidly growing industry, allows players to create fantasy teams of real-life players and potentially win cash prizes, derived from entry fees. Some stakeholders have expressed concern that DFS's accelerated nature and other features might promote excessive play and related harm. We conducted the first descriptive summary of actual DFS play using records from a cohort of subscribers to a dominant operator, DraftKings. Participants (N = 10,385) initially entered paid National Football League (NFL) contests. Across all participants, players entered a median of two contests per entry day and typically submitted a single entry for each contest they entered. Players paid a median of $87 in entry fees throughout the 2014 NFL season and experienced an overall median net loss of $30.7. However, we identified heavily involved sub-groups of players based on number of contests entered, total entry fees, and net loss. These top 1% groups were less likely to restrict themselves to NFL games, exhibited greater time involvement, but also won a greater percentage of the contests they entered than typical players. Our observations of typical and heavily involved players tend to mirror those generated in previous Internet sports gambling research. [ABSTRACT FROM AUTHOR]

Aim: Despite significant reductions in Driving Under the Influence (DUI) in the United States during recent decades, DUI continues to be a major public health threat. The current study investigated the intersection of two domains known to influence DUI: criminal history and psychiatric comorbidity.Methods: DUI recidivists (N = 743) attending a court-mandated two-week inpatient DUI program completed a computerized mental health assessment as part of their intake to that program. Participants' criminal records were obtained 4-5 years after program attendance.Findings: This study identified three primary repeat DUI offender subtypes with distinct patterns of criminal behavior and psychiatric comorbidity: (Type I) those whose DUI emerges from a pattern of drinking to cope with mood and anxiety problems, (Type II) those whose DUI emerges as part of a larger pattern of externalizing and criminal behavior, and (Type III) those whose DUI offenses reflect more acute triggers and isolated episodes of excessive drinking.Conclusion: These findings suggest that current treatment models used in DUI programs are inadequate to address the heterogeneity in the population of DUI recidivists and that earlier and more comprehensive screening would allow for better targeting of resources to DUI offender subtypes. [ABSTRACT FROM AUTHOR]

During 2011, the Governor of Massachusetts signed a bill to allow casino gambling in the state (Commonwealth of Massachusetts 2011). As a result, two resort casinos will begin operations during 2018 and 2019; a smaller slots parlor began operations during June 2015. Prior to this expansion, gambling was widely available in Massachusetts, through the state lottery, off-track betting, and gambling opportunities available in neighboring states. Within this context, it is important to understand the patterns of gambling involvement in the population prior to gambling expansion. The current study examined gambling involvement, patterns of play, and gambling-related problems prior to gambling expansion among a sample of 511 Massachusetts residents who were members of a statewide Internet panel. To measure patterns of play, we asked questions about past-year games played and frequency of play. To measure breadth of involvement, we assessed the number of different games played. To measure depth of involvement, we measured time spent gambling, amount wagered, and amount won or lost. Principal component analysis revealed four play pattern components accounting for more than 50% of the variance in game play frequency. Multiple regression analyses revealed that component scores composed of casino gambling and skill-based gambling (e.g., poker, sports) variables uniquely contributed to the prediction of gambling-related problems, even when depth of involvement was controlled. However, the addition of breadth of involvement to the model resulted in a model where no set of variables contributed significantly, suggesting a complex relationship among play patterns, depth, and breadth of involvement. The study established discrete and distinguishable gambling play patterns associated with gambling-related problems and identified groups of individuals potentially vulnerable to the effects of gambling expansion. [ABSTRACT FROM AUTHOR]

In their review of Internet gambling studies, Auer and Griffiths (J Gambl Stud 30(4), 879-887, 2014) question the validity of using bet size as an indicator of gambling intensity. Instead, in that review and in a response (Auer and Griffiths, J Gambl Stud 31(3), 921-931, 2015) to a previous comment (Braverman et al., J Gambl Stud 31(2), 359-366, 2015), Auer and Griffiths suggested using "theoretical loss" as a preferable measure of gambling intensity. This comment extends and advances the discussion about measures of gambling intensity. In this paper, we describe previously identified problems that Auer and Griffiths need to address to sustain theoretical loss as a viable measure of gambling intensity and add details to the discussion that demonstrate difficulties associated with the use of theoretical loss with certain gambling games. [ABSTRACT FROM AUTHOR]

This study examined patterns of problematic internet use (PIU) among South Korean internet users to investigate the association between PIU and dissociative experiences. Five hundred and eight participants between 20 and 49 years old were recruited through an online panel survey. Using logistic regression analysis with PIU as the dependent variable, we observed that the participants with PIU were more likely to have alcohol-related behaviors or problems, higher levels of perceived stress, and dissociative experiences. Participants’ scores on the Korean version of the Dissociative Experiences Scale were positively correlated with the severity of PIU. Individuals with PIU and dissociation had more severe PIU and more severe mental-health problems than those with PIU but without dissociation. These findings suggest that treatment programs for persons with PIU should focus on helping them tolerate negative affect and increase their level of awareness to prevent the occurrence of dissociative experiences. [ABSTRACT FROM AUTHOR]

Gaming industry employees are at higher risk than the general population for health conditions including gambling disorder. Responsible gambling training programs, which train employees about gambling and gambling-related problems, might be a point of intervention. However, such programs tend to use a "one-size-fits-all" approach rather than multiple tiers of instruction. We surveyed employees of one Las Vegas casino (n = 217) and one online gambling operator (n = 178) regarding their gambling-related knowledge and opinions prior to responsible gambling training, to examine the presence of natural knowledge groups among recently hired employees. Using k-means cluster analysis, we observed four natural groups within the Las Vegas casino sample and two natural groups within the online operator sample. We describe these natural groups in terms of opinion/knowledge differences as well as distributions of demographic/occupational characteristics. Gender and language spoken at home were correlates of cluster group membership among the sample of Las Vegas casino employees, but we did not identify demographic or occupational correlates of cluster group membership among the online gambling operator employees. Gambling operators should develop more sophisticated training programs that include instruction that targets different natural knowledge groups. [ABSTRACT FROM AUTHOR]

Abstract: Background: Prescribing benzodiazepines during buprenorphine treatment is a topic of active discussion. Clinical benefit is unclear. Overdose, accidental injury, and benzodiazepine misuse remain concerns. We examine the relationship between benzodiazepine misuse history, benzodiazepine prescription, and both clinical and safety outcomes during buprenorphine treatment. Methods: We retrospectively examined outpatient buprenorphine treatment records, classifying patients by past-year benzodiazepine misuse history and approved benzodiazepine prescription at intake. Primary clinical outcomes included 12-month treatment retention and urine toxicology for illicit opioids. Primary safety outcomes included total emergency department (ED) visits and odds of an ED visit related to overdose or accidental injury during treatment. Results: The 12-month treatment retention rate for the sample (N =328) was 40%. Neither benzodiazepine misuse history nor benzodiazepine prescription was associated with treatment retention or illicit opioid use. Poisson regressions of ED visits during buprenorphine treatment revealed more ED visits among those with a benzodiazepine prescription versus those without (p <0.001); benzodiazepine misuse history had no effect. The odds of an accidental injury-related ED visit during treatment were greater among those with a benzodiazepine prescription (OR: 3.7, p <0.01), with an enhanced effect among females (OR: 4.7, p <0.01). Overdose was not associated with benzodiazepine misuse history or prescription. Conclusions: We found no effect of benzodiazepine prescriptions on opioid treatment outcomes; however, benzodiazepine prescription was associated with more frequent ED visits and accidental injuries, especially among females. When prescribing benzodiazepines during buprenorphine treatment, patients need more education about accidental injury risk. Alternative treatments for anxiety should be considered when possible, especially among females. [Copyright &y& Elsevier]

Abstract: Alcohol identity is the extent to which an individual perceives drinking alcohol to be a defining characteristic of his or her self-identity. Although alcohol identity might play an important role in risky college drinking practices, there is currently no easily administered, implicit measure of this concept. Therefore we developed a computerized implicit measure of alcohol identity (the Alcohol Identity Implicit Associations Test; AI-IAT) and assessed its reliability and predictive validity in relation to risky college drinking practices. One hundred forty-one college students completed the AI-IAT. Again 3- and 6-months later, we administered the AI-IAT and indices of engagement in risky college drinking practices. A subset of participants also completed the previously-validated implicit measure of alcohol identity. Scores on the AI-IAT were stable over time, internally consistent, and positively correlated with the previously-validated measure of alcohol identity. Baseline AI-IAT scores predicted future engagement in risky college drinking practices, even after controlling for standard alcohol consumption measures. We conclude that the AI-IAT reliably measures alcohol identity, a concept that appears to play an important role in risky college drinking practices. [Copyright &y& Elsevier]

Abstract: Outpatient-based opioid treatment (OBOT) with buprenorphine is an important treatment for people with opioid dependence. No quantitative empirical research has examined rationales for use of illicit buprenorphine by U.S. opioid-dependent treatment seekers. The current study sequentially screened OBOT admissions (n = 129) during a 6-month period in 2009. This study had two stages: (a) a cross-sectional epidemiological analysis of new intakes and existing patients already receiving a legal OBOT prescription (n = 78) and (b) a prospective longitudinal cohort design that followed 76% of the initial participants for 3 months of treatment (n = 42). The primary aims were to establish 2009 prevalence rates for illicit buprenorphine use among people seeking OBOT treatment, to use quantitative methods to investigate reasons for this illicit use, and to examine the effect of OBOT treatment on illicit buprenorphine use behavior. These data demonstrate a decrease in illicit use when opioid-dependent treatment seekers gain access to legal prescriptions. These data also suggest that the use of illicit buprenorphine rarely represents an attempt to attain euphoria. Rather, illicit use is associated with attempted self-treatment of symptoms of opioid dependence, pain, and depression. [Copyright &y& Elsevier]

Objective: Evolving privacy and confidentiality regulations make achieving high completion rates in longitudinal studies challenging. Periodically reviewing the methods researchers use to retain participants throughout the follow-up period is important. We review the effectiveness of methods to maximize completion rates in a 1-year longitudinal study of repeat driving-under-the-influence (DUI) offenders. Method: During the course of 21 months, we attempted to follow-up with 704 participants of a licensed residential treatment facility for repeat DUI offenders. High rates of lifetime Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, substance-use disorders (97.6%) and nonsubstance- or nongambling-related psychiatric disorders (44.5%) among the sample made tracking participants difficult. To locate participants and complete follow-up interviews, we obtained baseline information, contacted collaterals, sent mailed reminders, searched Internet databases, and gave a monetary incentive for completing study interviews. Results: We located 608 participants with active telephone numbers (87.4%) and completed interviews with 488 (70.1% of the entire eligible sample and 80.3% of those with active telephone numbers), after an average (SD) of 8.6 (9.1) calls (median = 5.0). Increasing the number of calls continued to yield additional completions at 10, 20, and 30 calls; at approximately 40 telephone calls, the potential return for additional calls did not justify the added effort. Conclusions: These results suggest that researchers need to (1) employ more than 10 telephone calls to adequately track difficult-to-follow substance-using populations, and (2) prepare for a subsample of participants who might require more extensive contact. These results highlight the importance of using empirical guidelines to plan estimates for the number of contacts needed to achieve an adequate follow-up completion rate. [ABSTRACT FROM AUTHOR]

Abstract: Internet gambling is a potential object of addictive behavior and consequently an important concern for public health. Epidemiological analyses of Internet gambling are necessary to determine the extent of public health threat. This paper reports the results of the first prospective epidemiological study of actual Internet poker gambling behavior. Participants were 3445 Internet gambling service subscribers who enrolled during February 2005. Data include two years of recorded poker outcomes (i.e., chips bought and sold) for each poker session played. Among our sample, we identified two subgroups of poker players. Approximately 95% of the sample bought a median of €12 worth of chips at each of two poker sessions per week during a median duration from first to last bet of six months. A smaller subgroup (i.e., 5%) of most involved poker players bought a median of €89 worth of chip at each of 10 sessions per week during a median duration from first to last bet of 18 months. In addition to level differences, we report the differences in patterns of behavior observed between these two subgroups. The analyses presented in this paper suggest that the majority of Internet poker players moderated their behavior based on their wins and losses. A minority of most involved players did not show such moderation. These results have important implications for both gambling-and addiction-related research. [Copyright &y& Elsevier]

Abstract: The Internet is a controversial new medium for gambling. This study presents the first longitudinal analysis of online gambling participation and activity among a population of newly subscribed Internet bettors. Our analyses indicate that this population of gamblers adapted to the new subscription service rapidly, as evidenced by quickly developing declines in population participation, number of bets, and size of stakes. Adaptation was not uniformly evident in our population. Among subgroups of heavily involved bettors, adaptation was generally slower or not apparent. Rather than adapt, involved bettors often maintained the high level of betting they escalated to in the days following subscription. This was particularly evident for one type of game: live-action betting. These involved individuals and the effect of live-action play require close scrutiny and ongoing examination. [Copyright &y& Elsevier]

Objective: Driving under the influence (DUI) continues to be a serious public health concern in the United States. Research suggests that the substance use/abuse and psychiatric histories of repeat of- fenders might contribute to the persistence of this phenomenon. Because psychiatric histories could be important to recovery and likely differ substantially between men and women, the present study examined psychiatric and substance-use histories of male. and female DUI repeat offenders in treatment. Method: Seven hundred twenty-nine residents at the Middlesex Driving Under the Influence of Liquor program in Tewksbury, MA, a licensed residential facility providing treatment and education to repeat DUI offenders, participated in the current study during the course of 12 months. These participants completed a standardized diagnostic interview-12 modules of the Composite International Diagnostic Interview-as part of their intake interview. Results: Female repeat offenders in this study were substantially different from male repeat offenders in lifetime and past-year psychiatric co-morbidity patterns. Women had more extensive histories of psychiatric morbidity (i.e., psychiatric disorder in addition to substance abuse/dependence, alcohol abuse/dependence, and pathological gambling) and were more likely than men to report a history of multiple morbidities (i.e., multiple psychiatric disorders in addition to substance-related or gambling disorders). Conclusions: Both male and female repeat DUI offenders have extensive but different psychiatric histories that might play a significant role in DUI recidivism. These differences in psychiatric and substance-use histories among men and women could have important implications for treatment and prevention of DUI. (1 Stud. Alcohol Drugs 69: 209-217, 2008) [ABSTRACT FROM AUTHOR]

Gambling on college and professional sports and the influence of attending colleges with differing levels of ‘sports interest’ were examined among athletes, sports fans, and other students (N = 10,559) at 119 colleges in the United States using multilevel statistical analysis. Athletes and fans reported more sports gambling compared to other students, with no differences between athletes and fans. Male students were more likely to gamble than female students, but gender did not moderate the relationship between athletic participation and sports gambling. Students attending schools with a greater ‘sports interest’ were more likely to gamble on college sports after adjusting for individual characteristics. Athletes, sports fans, and students attending schools with high ‘sports interest’ are appropriate targets for prevention efforts. [ABSTRACT FROM AUTHOR]

Confronted with criticisms focused on the nature of Responsible Gambling (RG), this article suggests that Positive Play (PP) is a conceptual subset of Responsible Gambling and not a fully developed and independent harm prevention or reduction framework. To advance public health initiatives and focus public policy. This article reviews and clarifies some of the confusing and subtle difference between Responsible Gambling and Positive Play. The discussion defines the notion of responsibility, Responsible Gambling, and Positive Play. We recognize that well-developed RG activities permit and encourage the underpinnings of PP. However, when viewed as a dependent measure, PP does not intend to reduce the prevalence of gambling-related harms or prevent the incidence of gambling-related harms. These objectives are the two basic and fundamental requirements to classify any activity as a RG program., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

In this comment, we suggest there has been a crusade among some gambling stakeholders to move the field away from personal responsibility influences and toward social setting effects. This perspective disproportionally attributes gambling-related negative consequences to the social setting rather than the gambler. We argue that personal responsibility is a pivotal issue during the emotional maturation of healthy adults and remains essential to understanding intemperate gambling. This comment explores this movement away from personal responsibility and briefly discusses some of the iatrogenic consequences that this position might create in a clinical setting., (© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Purpose of Review: Posttraumatic stress disorder (PTSD) commonly co-occurs with substance use disorder (SUD) and is challenging to treat. We review all behavioral therapy models with at least one randomized controlled trial in a current PTSD/SUD population. We identify factors in selecting a model for clinical use, emphasizing a public health framework that balances the need for evidence with the need for feasibility in frontline settings., Recent Findings: Seven published models and 6 unpublished models are reviewed. Public health considerations for choosing a model include: whether it's been studied across a broad range of SUDs and in complex SUD patients; whether it can be conducted in group modality; its appeal to patients and providers; its cost; workforce requirements; and its ability to reduce substance use in addition to PTSD., Summary: There are two broad types of models: those that originated in the PTSD field versus the SUD field. Overall, the latter are stronger on public health factors and more feasible in SUD settings. Published models in this category include Relapse Prevention, BRENDA, and Seeking Safety. PTSD/SUD research is at an early stage and there is a need for methodology that quantifies "level of burden" (patients' socioeconomic disadvantages) across trials.

This paper discusses the relationship between investigative credibility and the sources of funding associated with gambling research. Some researchers argue against accepting funding from gambling industry sources; similarly, they decline to participate in activities directly or indirectly sponsored by gambling industry sources. In contrast, these anti-industry investigators evidence less resistance toward accepting funds from sources other than industry, for example, governments, because they believe that they have greater independence, reliability, and validity, and less undue influence and/or interference. We organize this article, around six primary issues: (1) researchers making a priori judgments that restrict positions towards industry associated research; (2) the potential negative impacts of holding such a position; (3) a description of the different sources of funding available to support gambling-related research; (4) an examination of the extant empirical support associated with the sources of funding and whether such support evidences bias; (5) a description of six cases illustrating how refusing to participate in any project funded by the industry can adversely influence the advancement of science and, at times, be itself unethical; and finally, (6) we suggest some remedies to advance solutions to this problem by stimulating the participation of reluctant researchers to work towards a greater harmony, keeping in mind that the pivotal goal of our work is to increase our knowledge in different area of science and to harness it to public goods.

Social networks play important roles in mental and physical health among the general population. Building healthier social networks might contribute to the development of self-sufficiency among people struggling to overcome homelessness and substance use disorders. In this study of homeless adults completing a job- and life-skills program (i.e., the Moving Ahead Program at St. Francis House, Boston), we prospectively examined changes in social network quality, size, and composition. Among the sample of participants (n = 150), we observed positive changes in social network quality over time. However, social network size and composition did not change among the full sample. The subset of participants who reported abstaining from alcohol during the months before starting the program reported healthy changes in their social networks; specifically, while completing the program, they re-structured their social networks such that fewer members of their network used alcohol to intoxication. We discuss practical implications of these findings.

The RENO Model, first published during 2004, described a science-based framework of responsible gambling principles for a range of industry operators, health service providers, community and consumer groups, and governments. These strategic principles serve as a guide for the adoption and implementation of responsible gambling and harm-minimization initiatives. This article extends the RENO Model core principles by describing how to apply these strategies to clinical practice. This discussion examines the central tenets of the model and includes a review of (a) the ethical principles that should guide the development, implementation, and practice of RENO Model responsible gambling activities; (b) a brief consideration of the various perspectives that influence the treatment of gambling-related problems; and (c) a discussion of key applied elements of responsible gambling programs. This article advances the argument that, to maximize positive outcomes and to avoid unintended harms, clinicians should apply science-based principles to rigorously evaluate the efficacy and impact of their clinical practice activities. (PsycINFO Database Record, ((c) 2016 APA, all rights reserved).)

As rates of Internet gambling participation increase worldwide, so too does the need to understand how people engage in this form of gambling. This study represents the first examination of actual Internet gambling records within Iceland, a Nordic country with an active Internet lottery market that imposes strict regulations on gambling operator licenses. We summarized electronic betting records of a cohort of subscribers to the Internet betting service provider Íslensk Getspá. We observed that the typical subscriber bet approximately 3 days per month and made fewer than two bets per gambling day, each worth approximately the equivalent of $4 US. Subscribers lost the bulk (96%) of the amount they wagered, for a total loss of approximately $40 across the 2-year window of observation. Although these observations do not support the view of Internet gambling as an activity that is inherently risky for the typical subscriber, we did observe discontinuity across the distributions of gambling behavior, with the top 1% of subscribers making more than three bets per day.

In their review of Internet gambling studies, Auer and Griffiths (Soc Sci Comput Rev 20(3):312-320, 2013) question the validity of using bet size as an indicator of gambling intensity. Instead, Auer and Griffiths suggest using "theoretical loss" as a preferable measure of gambling intensity. This comment identifies problems with their argument and suggests a convergent rather than an exclusionary approach to Internet gambling measures and analysis.

Psychiatric comorbidity has emerged as a key element distinguishing DUI offenders from others, and, in some cases, distinguishing repeat offenders from first-time offenders. This paper utilizes a prospective design to determine whether the comorbid disorders identified among repeat DUI offenders can predict recidivism. Seven hundred forty-three repeat DUI offenders were recruited from a two-week inpatient treatment program at which they received a standardized mental health assessment and followed across five years post-treatment to track DUI offense, motor vehicle-related offenses, and general criminal offenses. Psychiatric comorbidity, though it did not predict DUI recidivism specifically, predicted criminal re-offense more generally. In addition, there was a specific relationship between lifetime attention deficit disorder and repeated motor vehicle-related offenses. These findings suggest that for many repeat offenders, DUI is one outlet in a constellation of criminal behavior, and that psychiatric comorbidity increases vulnerability for criminal re-offense.

A growing literature is addressing the nature of the relationships among gambling activity, gambling involvement, and gambling-related problems. This research suggests that among the general population, compared to playing any specific game, gambling involvement is a better predictor of gambling-related problems. To date, researchers have not examined these relationships among casino patrons, a population that differs from the general population in a variety of important ways. A survey of 1160 casino patrons at two Las Vegas resort casinos allowed us to determine relationships between the games that patrons played during the 12 months before their casino visit, the games that patrons played during their casino visit, and patrons' self-perceived history of gambling-related problems. Results indicate that playing specific gambling games onsite predicted (i.e., statistically significant odds ratios ranging from .5 to 4.51) self-perceived gambling-related problems. However, after controlling for involvement, operationally defined as the number of games played during the current casino visit and self-reported gambling frequency during the past 12 months, the relationships between games and gambling-related problems disappeared or were attenuated (i.e., odds ratios no longer statistically significant). These results extend the burgeoning literature related to gambling involvement and its relationship to gambling-related problems.

This study examines the impact of a work-skills program grounded in an integrated services approach on both employment and related life domains among homeless individuals. Six hundred thirty-eight participants in a 14-week work-skills program at a large day center in New England completed assessments at intake between 1999 and 2007; a subsample of 333 also completed assessments at graduation from the program; a smaller subsample of 55 participants were re-assessed 6 months after graduation. These assessments measured work and related life skills, employment, housing status, general health status, substance use, self-esteem and self-efficacy, and legal involvement. Results revealed improvement in all types of work and related life skills, employment and income, and multiple other life domains from baseline to graduation and follow-up. Exploratory analyses suggested that improvements in work and related life skills were associated with improvement in self-esteem and self-efficacy, and that these improvements predicted stable housing situations at follow-up. Overall, these findings indicate that, for individuals struggling with the challenges of homelessness, completion of a work-skills program has a positive impact on skills and employment, and on a diverse set of life domains.

Gaming industry employees work in settings that create personal health risks. They also have direct contact with customers who might engage in multiple risky activities (e.g., drinking, smoking, and gambling) and might need to facilitate help-seeking by patrons or co-workers who experience problems. Consequently, the empirical examination of the processes and procedures designed to prepare employees for such complex situations is a public health imperative. In the current study we describe an evaluation of the Casino, Inc. Play Responsibly responsible gaming program. We surveyed 217 employees prior to and 1 month after (n = 116) they completed a multimedia driven responsible gambling training program. We observed that employees improved their knowledge of responsible gambling concepts from baseline to follow-up. The Play Responsibly program was more successful in providing new knowledge than it was in correcting mistaken beliefs that existed prior to training. We conclude, generally, that Play Responsibly is associated with increases in employees' responsible gambling knowledge.

Many international jurisdictions have introduced responsible gambling programs. These programs intend to minimize negative consequences of excessive gambling, but vary considerably in their aims, focus, and content. Many responsible gambling programs lack a conceptual framework and, in the absence of empirical data, their components are based only on general considerations and impressions. This paper outlines the consensus viewpoint of an international group of researchers suggesting fundamental responsible gambling principles, roles of key stakeholders, and minimal requirements that stakeholders can use to frame and inform responsible gambling programs across jurisdictions. Such a framework does not purport to offer value statements regarding the legal status of gambling or its expansion. Rather, it proposes gambling-related initiatives aimed at government, industry, and individuals to promote responsible gambling and consumer protection. This paper argues that there is a set of basic principles and minimal requirements that should form the basis for every responsible gambling program.

Internet gambling is growing rapidly, as is concern about its possible effect on the public's health. This paper reports the results of the first prospective longitudinal study of actual Internet sports gambling behavior during eight study months. Data include recorded fixed-odds bets on the outcome of sporting contests and live-action bets on the outcome of events within contests for 40,499 Internet sports gambling service subscribers who enrolled during February 2005. We tracked the following primary gambling behaviors: daily totals of the number of bets made, money bet, and money won. We transformed these variables into measures of gambling involvement. We analyzed behavior for both fixed-odds and live-action bets. The median betting behavior of the 39,719 fixed-odds bettors was to place 2.5 bets of 4 euro (approximately $5.3 US) every fourth day during the median 4 months from first to last bet. This typical pattern incurred a loss of 29% of the amount wagered. The median betting behavior of the 24,794 live-action bettors was to place 2.8 wagers of 4 euro every fourth day during the median duration of 6 weeks at a loss of 18% of the amount wagered. We also examined the behavior of empirically determined groups of heavily involved bettors whose activity exceeded that of 99% of the sample.

The purpose of this preliminary study was to examine associations between leaving home to engage in bingo or gambling activity and indices of physical and mental health and social support among a representative community cohort of 1016 elderly people. Cross-sectional and longitudinal data gathered from a prospective epidemiological study in a rural, low socio-economic status, area of Pennsylvania was employed. The cohort had a mean age of 78.8 (SD = 5.1) (range 71-97) and participated in three consecutive biennial "waves" of data collection. Nearly half (47.7) of the cohort reported gambling. To predict gambling, the independent variables included age, sex, education, employment, social support, depressive symptoms, self-rated health, alcohol use, cigarette use, and cognitive functioning. In cross-sectional, univariate analyses, gambling was associated with younger age, sex (male), fewer years of education, greater social support, lower depression scores, better self-rated health, alcohol use in the past year, and higher cognitive functioning. In a cross-sectional multiple regression model, younger age, greater social support, and alcohol use in the past year remain strongly and independently associated with gambling activity. Longitudinally, age, sex, social support, alcohol use, and gambling are predictive of future gambling activity. The results revealed that gambling may offer a forum of social support to older adults who are often isolated as they age.