The Chase: Predecessors and Progress on Problem Gambling

1. The Chase: Predecessors and Progress on Problem Gambling Henry R. Lesieur, Ph.D., Psy.D. Rhode Island Hospital Gambling Treatment Program Providence, RI Alberta Gaming Research Institute Annual Conference, Banff, Alberta, April 2008 hlesieur@lifespan.org http://www.gamblingtreatment.org

2. Major Questions to be Addressed • What was known about problem gambling before The Chase? • What broad socio-cultural patterns preceded the era of modern research? • What was occurring simultaneous to The Chase? • What research and social trends have occurred after The Chase?

3. Gambling in History • Gambling has existed in most cultures and in prehistory. • Religion, law and play intermingled. • Lots were used to determine the will of the gods. • Lots were cast to determine guilt or innocence.

4. Astragal

5. Gambling as Problematic • Evidence that gambling was a problem for some existed but there does not appear to be much social commentary on it. There are myths about heavy losses among the gods (Ancient India). • Ancient Egyptians outlawed gambling among the masses (slavery in the salt mines was a penalty for violation). • Nero and Caligula were notorious cheats and loaded dice were found in Pompeii. • Individual problem gambling was mixed in with cheating in the law.

6. Gambling as Problematic in North America • In the year before I started doing gambling research, I searched through the Human Relations Area Files for gambling in North America. • For many tribes, gambling was ubiquitous, yet culturally controlled.

7. Stick Dice

8. Social Controls among First Nations People • The Mohave (along the Colorado River in Arizona, California & Nevada) made gambling a formalized, ritualized occasion. Gambling was instrumental to the ritual rather than affectively loaded. • Gros Ventre of Montana had no promissory principle. No debts were incurred. • Yakima in Washington State gambled with surplus property only. Family property was gambled only with spousal consent. Both heavy winners and heavy losers gained prestige. Losers were not stigmatized. Again, no promissory notes.

9. Gambling as Problematic Among First Nations People • Only in rare circumstances were gambling problems mentioned in the Human Relations Area Files. • Among the Mandan Indians of the upper Missouri River, the Yurok of Northern California, the Bella Coola of BC you could become the property of someone else after losing. Problems among family members and loss of children to slavery also occurred. • At least one case of suicide after gambling losses was documented among the Iroquois in 1639.

10. Characteristics of the Age of Ignorance • Some cultures implement controls that seem to work • Gambling losses were tied in with cheating in some cultures. • Some cultures outlawed gambling because of the association with cheating. • In spite of it all, problem gambling existed and cases were documented on an anecdotal basis.

11. Age of Sin • Gambling per se was equated with evil • The gambler was either an exploiter or exploited • Focus on cheating, violating the law, and corruption • The player was viewed as a flawed victim

12. Skip to early 20th Century • Gambling and Gambling Devices: An Educational Exposition Designed to Instruct the Youth to Avoid All Forms of Gambling John Philip Quinn Published in 1912 • Quinn outlined the religious argument against gambling. He focused on crooked gambling devices

13. Three Stages of a Gambler’s Life

14. Three Stages of a Gambler’s Life 1. High hopes of pleasure. A life devoted to the ruin of his fellowmen. He “takes hold on hell.” 2. The Illusion is dispelled. He becomes a member of a villainous class. 3. He becomes a “fool of fortune … enslaved by his own degraded instincts.”

15. The Upward and Downward Way The Upward Way The Downward Way to God and family to prison and destitution

16. This continued:Sucker’s Progress: An Informal History of Gambling in America From the Colonies to CanfieldHerbert Asbury, 1938An “objective” history that is full of moralizing. For example, he quotes a New York Herald article: “There is a small and select number of very splendid hells in this city where young men with property are sent to perdition in no time.” From that point on he describes “gambling hells” in different parts of the US.

17. Continuation in late 20th Century – Ambivalence about sin and disease • National Coalition Against Legalized Gambling (US) • Arguments similar to those in the 19th and early 20th century but with the addition of an acceptance of the medical model. • See Suzanne Morton At Odds: Gambling and Canadians 1919-1969

18. Medicalization (prior to The Chase) • 1 – Psychoanalytic theorizing Freud; Bergler (1958); and others • 2 – Gamblers Anonymous (1957) • 3 – Robert L. Custer, MD (collected data from VA hospital in Brecksville, Ohio) (1972) • 4 – National Council on Compulsive Gambling (New York) (1972)

19. Bergler Psychology of Gambling

20. Number of States with Legal Gambling in the US – 1974 OTB Machines Parimutuel

21. Number of States with Legal Gambling in the US – 2005 Slots/VLTs OTBs Parimutuel

22. Gross Win in Billions of Dollars 1974-2004 (US)

23. Provinces & Territories with Legalized Gambling -- 1975 12 12 7 3 0 0 All had Bingo and Lottery by 1975 Casinos: only Alberta (1975), Manitoba (1971) & Yukon (1800s)

24. Provinces & Territories with Legalized Gambling -- 2005 12 12 12 11 10 8 Slots-all but NW & Yukon OTB-all but NFLD (has intertrack wagering)

25. Gambling Revenue – Statistics Canada $12.4 $11.3 $9 $6.8 $2.7

26. Narragansett Racetrack

27. Sociology of Problem Gambling prior to The ChaseBasically a Desert except for: • Edward Devereux Jr – Gambling and the Social Structure – 1949 – a study of the numbers racket and racetrack – excessive gambling conflicts with the basic tenets of the Protestant ethic and has dysfunctional consequences for the social system

28. Sociology of Deviance • Anti-medicalization • “Labeling Theory” • Symbolic Interaction and Phenomenology • Emphasis on Qualitative Research including participant observation and intensive interviews

29. Quitting Gambling Through Gamblers Anonymous • University of Massachusetts -- Sociology • TV show and my ex-boss • GA meetings in Connecticut • Ph.D. thesis • Observations & Interviews

30. Compulsive Gambler’s Spiral of Options and Involvement • Criminology – Missing Information in the Research Literature 1. Gambling as deviant behavior – Nothing about CGs in articles or textbooks 2. Gambling as crime 3. Gambling = Organized Crime 4. Nothing about route CGs take to Criminal Behavior

31. The Chase Book Cover

32. Methods Used (Qualitative) • Attended Gamblers Anonymous meetings CT, RI, MA & prisons (non-participant observation) • Intensive semi-structured, open-ended interviews (tape recorded) with • CGs (all white males) • Wives • Bookmakers • Loan sharks • Regular gamblers I knew from gas station • prisoners

33. The Chase • Short-term chasing -- normal • CG = long-term chasing • Understanding CG view of the world: Action: Chasing; Finances; Family; Work; Gambling as Illegal activity; Crime • CG Spiral of Options and Involvement

34. Spiral

35. Crime Types Among Pathological Gamblers • Forgery, Fraud, Theft, Embezzlement • Tax violations (fraud & evasion) • Illegal Gambling operation • Less common: Burglary, Armed robbery, Drug Sales, Fencing Stolen Goods, Prostitution, Extortion

36. Cycles in the Spiral ofOptions and Involvement 1. Get Money 2. “Moving,” “Manipulating,” or “Juggling” Money 3. Tightening of Resources (Closure) and Need to Make Moral Decision

37. Medicalization -- 1980 • American Psychiatric Association • Diagnostic and Statistical Manual of Mental Disorders, Third Edition • Lobbying occurred (e.g. gay community and the removal of homosexuality as a mental disorder in 1973; the removal of sexual orientation disturbance in 1980; and total removal in 1987).

38. American Psychiatric Association DSM-III and Robert L. Custer, MD • Brecksville VA Hospital – 1972 • Custer conducted research on the patients • Custer lobbied the American Psychiatric Association (DSM-III 1980) • Pathological Gambling included under “Disorders of Impulse Control, NEC” along with kleptomania, pyromania, intermittent explosive disorder and trichotillomania

39. Custer V Chart

40. Medical Model continued DSM-III-R & DSM-IV • Critique of DSM-III (sexist & ignorance of criminals with gambling problems) • Generated DSM-III-R questionnaire • DSM-IV with Richard Rosenthal, MD • Survey of people in treatment (alcohol & gambling) • Used non-problem gambling alcoholics as controls

41. Significant Changes Commencing in the 1980s and Continuing • Development of measures (SOGS etc.) • Research on subgroups • Population studies • New Journal • Research and Programs Leapfrogged around the world

42. South Oaks Hospital & Sheila Blume, MD • Alcohol, Drug Abuse & Gambling • Gambling among mental patients • South Oaks Gambling Screen • Gambling Severity Index • Evaluation of inpatient gambling treatment program

43. Africaans Arabic Cambodian Chinese Czech Danish Dutch English Farsi Estonian Finnish French German Greek Hindi Hmong Icelandic Italian Japanese Laotian Maori Norwegian Polish Polynesian Portuguese Russian Sesotho Somali Spanish Swedish Tagalog Thai Turkish Urdu Vietnamese Xhosa Zulu SOGS Translations 37 languages so far Note: translations in Croatian and Slovenian in progress

44. Epidemiological Surveys • Only one existed worldwide, US in 1974 (this happened when I was doing research for The Chase) • Since then, numerous surveys have been conducted by a wide range of highly skilled researchers initially following the medical model and gradually widening the focus to broader perspectives

45. General population studies College/University students Substance abusers Psychiatric patients Patients in general practice Gaming Patrons College Athletes College Sports officials Prisoners Youth Incarcerated youth Gaming employees Minority groups Older adults Special populations Surveys have been conducted with the following groups

46. Proliferation of Measures (only measures used by more than one researcher included) • SOGS • SOGS-R – Volberg & Abbott • SOGS-RA – Stinchfield & Winters • NODS – NORC Diagnostic Screen • CPGI – Canadian Problem Gambling Index • Eight Screen – Sullivan (New Zealand) • DIS – Diagnostic Interview Schedule • DIGS – Diagnostic Inventory of Gambling Severity – Winters, Specker & Stinchfield • DSM-IV-J -- Fisher

47. Outcome Measures(only measures used by more than one researcher included) • SOGS-3 month version • DSM-IV -- # criteria met • GSI – Gambling Severity Index (Lesieur & Blume) • G-SAS – Gambling System Rating Scale (Kim) • PG-YBOCS -- Hollinger

48. JGB (1985) & JGS (1990)

49. Journals since JGB • The Wager (1996) – not a journal but provides summaries of research • Gaming Research and Review Journal (primarily casino & regulatory) (1994) • Gaming Law Review (1997) • eGambling (2000)  Journal of Gambling Issues (Dec 2004) – based in Ontario • International Gambling Studies (2001) – Based in Australia

50. Research from the UK on Youth Gambling • Mark Griffiths – studies of fruit machine gambling among youth (methods varied) • Sue Fisher – field research among youth playing fruit machines in Seaside towns in UK • Raised prospect that gambling problems may reach into very young groups • Mantle taken up by Derevensky (& later Gupta) at McGill