变态心理学论文

the main purpose of this study was to establish a baseline measure of the prevalence of gambling and gambling-related problems among the adult population in Oregon. An additional purpose of this study was to identify the types of gambling causing the greatest difficulties for the citizens of Oregon. The results of this study will be useful in documenting the impact of legal gambling on the citizens of the State of Oregon. The results will also be valuable in formulating statewide policy with regard to legal gambling in Oregon. The results of this study show that significant numbers of Oregon residents participate in legal gambling, that these activities are widely accepted, and that most residents spend small to moderate amounts on gambling. However, the study also shows that there is a significant number of Oregon residents who are currently experiencing severe difficulties related to their gambling involvement. Contrary to arguments by the media and even some treatment professionals, video poker is not the only type of gambling causing difficulties for the citizens of Oregon nor are those difficulties disproportionately higher than in other jurisdictions. The implications of this finding for the field of problem gambling research as well as for gambling policy development in Oregon are far-reaching. Summary In 1997, nearly nine out of ten respondents in Oregon acknowledge participating in one or more types of gambling at some time in their lives. Lifetime gambling participation in Oregon is highest for the lottery, charitable games and casinos or Indian Gaming Centers. As in other jurisdictions, young men with relatively high income are the respondents in Oregon most likely to have ever gambled. In Oregon, of the respondents scored as lifetime problem gamblers and an additional of the respondents scored as lifetime probable pathological gamblers. In contrast, of the respondents scored as current problem gamblers while of the respondents scored as current probable pathological gamblers. Overall, the lifetime prevalence of problem and pathological gambling in Oregon is while the current prevalence rate in Oregon is . The lifetime prevalence rate in Oregon is lower than in other Western states while the current prevalence rate is higher than in many other states. Lifetime problem gamblers in Oregon are significantly more likely than other respondents to be male, under the age of 30, non-White and divorced, separated or never married. Despite these significant differences, however, it is important to remember that the majority of lifetime and current problem gamblers are White and between the ages of 30 and 54. In contrast to lifetime problem gamblers, current problem gamblers are just as likely to be women as men. Problem gamblers in Oregon are most likely to gamble weekly on the lottery, video poker, games of skill and at Indian Gaming Centers. Problem gamblers are more likely than non-problem gamblers to spend three or more hours gambling in a typical session and to have lost $100 or more in a single day. Use of the DSM-IV Screen in the Oregon survey provided a valuable opportunity to improve our understanding of the DSM-IV Screen in relation to the South Oaks Gambling Screen. Comparison of these two screens shows that they are highly consistent. Our analysis suggests that the cutoff point for the DSM-IV Screen may be too severe and that using a separate classification for individuals who score three or four points on the DSM-IV Screen would allow the screen to capture individuals whose pathology is well-developed but perhaps not yet extreme. Directions for the Future The costs of gambling problems can be high, not only for individuals but for families and communities. Pathological gamblers experience physical and psychological stress and exhibit substantial rates of depression, alcohol and drug dependence and suicidal ideation. The families of pathological gamblers experience physical and psychological abuse as well as harassment and threats from bill collectors and creditors. Other significant impacts include costs to employers, creditors, insurance companies, social service agencies and the civil and criminal justice systems. The first step usually taken by governments in response to an emerging social problem is to determine the number of individuals who may be in need of assistance as a result of a specific government policy or activity. The next step is to develop a range of services for affected individuals and their families. In the wake of widespread gambling legalization in the 1980s and 1990s, governments have moved forward in implementing measures to educate the public as well as treatment professionals and gaming operators about problem gambling. How Many To Plan For? The first step in developing rational policy with regard to legal gambling has now been taken in Oregon by funding the prevalence study reported here. One important purpose of a prevalence survey is to identify the number of individuals in a jurisdiction who may need treatment services for gambling-related difficulties. Experience in many jurisdictions suggests that not all of the individuals in need of treatment for a physical or psychological problem will seek out such treatment. From a policy perspective, the question is: How many individuals should we plan to provide for? Recently, researchers in Australia have successfully used an approach adopted from the alcoholism treatment field to predict the proportion of individuals in need of problem gambling treatment services who would access such services. Research suggesting that approximately 3% of individuals with severe alcohol-related difficulties actually seek treatment was replicated in predicting the number of problem gamblers who would seek treatment in two Australian states (Dickerson 1997). In calculating the number of problem and pathological gamblers who might seek treatment in Oregon, we focus on the group of individuals who score as current probable pathological gamblers (. the 18,900 to 47,200 individuals represented by the confidence interval for current probable pathological gambling in Oregon). Based on this approach, we estimate that the State of Oregon should plan to provide problem gambling treatment services to between 600 and 1,400 individuals per year. The reliability of this estimate is enhanced when we consider that the problem gambling treatment programs in Oregon have an average monthly enrollment of 46 problem gamblers and 5 family members or an average of 550 problem gamblers and 60 family members per year. Recommendations Given the possible expansion of legal gambling in Oregon to include slot machines at restaurants, bars and taverns, it will be important to maintain current services for problem gamblers in Oregon as well as education and prevention services for individuals who are at risk for developing gambling-related difficulties. In making decisions about implementing services for problem gamblers and their families in Oregon, policy-makers, the Association of Oregon Community Mental Health Programs (AOCMHP), the Oregon Gambling Addiction Treatment Foundation (OGATF) and others may wish to give consideration to developing the following services and activities: research activities including a thorough examination of the prevalence and characteristics of problem gamblers among under-served and/or minority groups, among Oregon's youth, and at the county level in areas where Indian Gaming Centers may be located; ?development of innovative treatment alternatives to provide a variety of options for individuals seeking help for gambling problems; ?expanded training opportunities to educate mental health, alcohol and substance abuse treatment professionals in how to screen for gambling problems and pathology as well as when and where to refer such individuals for appropriate treatment; ?establishment of a gambling counselor certification program to ensure that individuals seeking help for gambling-related difficulties receive appropriate and effective services; ?b> development of public education and prevention services targeted toward at-risk and under-served groups in the population, including young males and women problem gamblers, as well as toward specific types of gambling, including video poker and lottery outlets and casinos within the state; ?development of responsible gaming policies and programs by the Oregon Lottery and the Native American gaming centers for staff and retailers; ?continued evaluation of existing program services as well as those established in the future; and ?continued monitoring of gambling and problem gambling prevalence in the state to assess the impacts of the introduction of new types of legal gambling on the residents of Oregon and to refine existing efforts to minimize the negative impacts of gambling. This report represents the first assessment of rates of gambling and problem gambling in Oregon. The data from this survey provide insights that will be valuable in on-going policy and planning efforts in the state. In the future, it will be important for everyone involved with legal gambling in Oregon to continue to work together to develop ways to help the citizens of Oregon who experience difficulties related to their gambling and to prevent any future increases in the prevalence of problem gambling in the state.