Addiction: A treatise from 1561.

BACKGROUND AND AIMS: In 1561, physician and philosopher Pascasius Justus Turq published a monograph on the description and treatment of pathological gambling. When the monograph came to the attention of the authors in 2006, there existed no known translation of it in any modern language. In 2014, it was translated and published in French. This paper analyses the monograph's key content elements and its place in the history of the concept of addiction. METHODS: A contextual analysis of the late Italian Renaissance, followed by key excerpts from the text and commentaries on the meaning and significance of the monograph. FINDINGS AND CONCLUSIONS: Pascasius Justus Turq's 1561 monograph on pathological gambling outlines a disease view of gambling, identifies cognitive processes and biological vulnerabilities as aetiological factors, avoids religious or moral judgements and recommends cognitive treatment to change the beliefs and expectancies of gamblers. This study shows that a 'disease formulation' of addiction was enunciated as early as the 16th century, and its contemporary resonance suggests that current clinical features of addictive disorders have existed for centuries.

Do the Consequences Experienced by the People in the Life of a Problem Gambler Differ Based on the Nature of Their Relationship with the Gambler?

Consequences experienced by the partners of individuals with a gambling disorder are well documented. However, little is known about the deleterious effects experienced by other people than partners of gamblers. A better understanding of these consequences could help improve clinical practices. The goal of this paper is to compare the consequences experienced by partners of gamblers with those experienced by their close family members (parents, adult children, siblings) by using the categorization method proposed by Langham et al. (BMC Public Health, 2016). To achieve this goal, 46 semi-structured interviews were conducted. Results indicate that the extent and intensity of the consequences experienced vary widely based on their level of emotional and financial involvement with the gambler. Considering the specific elements involved for each type of person in a gambler's life, future research should distinguish participants based on the nature of their relationship with the gambler.

A meta-analysis of problem gambling risk factors in the general adult population.

BACKGROUND AND AIMS: Few meta-analyses have been conducted to pool the most constant risk factors for problem gambling. The present meta-analysis summarizes effect sizes of the most frequently assessed problem gambling risk factors, ranks them according to effect size strength and identifies any differences in effects across genders. METHOD: A random-effects meta-analysis was conducted on jurisdiction-wide gambling prevalence surveys on the general adult population published until March 2019. One hundred and four studies were eligible for meta-analysis. The number of participants varied depending on the risk factor analyzed, and ranged from 5327 to 273 946 (52% female). Weighted mean odds ratios were calculated for 57 risk factors (socio-demographic, psychosocial, gambling activity and substance use correlates), allowing them to be ranked from largest to smallest with regard to their association with problem gambling. RESULTS: The highest odds ratio (OR) was for internet gambling [OR = 7.59, 95% confidence interval (CI) = 5.24, 10.99, P < 0.000] and the lowest was for employment status (OR = 1.03, 95% CI = 0.87, 1.22, P = 0.718). The largest effect sizes were generally in the gambling activity category and the smallest were in the socio-demographic category. No differences were found across genders for age-associated risk. CONCLUSIONS: A meta-analysis of 104 studies of gambling prevalence indicated that the most frequently assessed problem gambling risk factors with the highest effect sizes are associated with continuous-play format gambling products.

Gambling Self-Control Strategies: A Qualitative Analysis.

There is limited research exploring the perceptions of people who gamble on the self-control strategies used to limit their gambling. This qualitative study examines self-control strategies used to limit money spent gambling, frequency of gambling, and time spent gambling. A total of 56 people who gamble (27 males and 29 females) participated in nine focus groups and five individual interviews in Montreal, Calgary, and Toronto (Canada). Self-control strategies used to limit their gambling expenditure were more common than frequency or time limiting strategies. Strategies to limit expenditure included: restricting access to money; keeping track of money allocated to gambling activities; and avoiding certain types of gambling activities. Various contextual factors were identified to influence those strategies, including social influences; winning or losing; using substances. Findings from this study emphasize the importance of communicating clear gambling limits to people who gamble, as well as the value of developing individual self-control strategies to limit frequency, time and money spent gambling.

Once online poker, always online poker? Poker modality trajectories over two years.

Online poker is considered more at-risk than land-based poker in terms of intense gambling behaviors and gambling problems. The development of many online gambling sites has raised public health concerns about the potential increase in online poker players. Longitudinal studies are useful to better understand the evolution of gambling behaviors; however, very few consider online poker players. Using a prospective design, this study aims to identify online and land-based trajectories over a two-year period and the factors influencing those trajectories. Results are based on data collected at three time-points over the course of a prospective cohort study conducted in Quebec (n = 304). A latent class growth analysis was performed to determine trajectories based on the main poker modality played, either online or land-based poker. Multinomial multivariable logistic regression analyses were conducted to determine the correlates of poker playing trajectories. Over two years, three poker playing trajectories were identified, comprising two stable trajectories [stable land-based (51.5%) and stable online (36.3%)] and an unstable trajectory [unstable online land-based (12.1%)]. The second trajectory included online poker players at baseline who transitioned to land-based poker. Number of gambling activities increased the odds of being in the first trajectory as compared to the others. Severity of gambling problems was a significant predictor of the second "unstable" or the third "stable online" trajectories, but not for the first "stable land-based" poker trajectory. The majority of poker players remained in either the land-based or online trajectories over two years. No poker players transitioned from land-based to online poker.

Cortisol stress response predicts 9-year risky driving convictions in male first-time driving-while-impaired offenders.

BACKGROUND: With driving while impaired by alcohol (DWI) representing a persistent burden on global health, better understanding and prevention of recidivism following a first-time DWI conviction are needed. Progress towards these goals is challenged by the marked heterogeneity in offender characteristics and a traffic safety literature that relies on subjective self-report measures and cross-sectional study designs. The present study tested the hypothesis that an objective neurobiological marker of behavioural maladjustment, the cortisol stress response (CSR), predicts future DWI and other traffic convictions over a 9-year follow-up period. METHODS: One hundred thirty-two male first-time DWI offenders and 31 non-offender comparators were recruited and assessed at intake for their substance use, psychosocial and psychological characteristics and CSR. Traffic conviction data were obtained from provincial driving records. Survival analysis estimated the association between CSR and risk of a traffic conviction over time. RESULTS: In support of our hypothesis, blunted CSR predicted traffic convictions during the follow-up duration. This effect generalized to both DWI offenders and non-DWI drivers. While CSR was lower in DWI offenders compared to non-offenders, it did not specifically predict recidivism in DWI offenders. Modelling results indicated that blunted CSR, along with DWI offender group membership, experience seeking and drug use frequency, may demarcate a high-risk driver phenotype. CONCLUSIONS: CSR is a neurobiological marker of a driver phenotype with elevated generalized driving risk. For drivers with characteristics consistent with this phenotype, expanding the focus of intervention to address multiple forms of risky driving may be necessary to curb their overall threat to traffic safety.

Gambling Problem Trajectories and Associated Individuals Risk Factors: A Three-Year Follow-Up Study Among Poker Players.

Despite the popularity in poker-related activities in recent years, few studies have focused on the evolution of gambling habits of poker players over a long period of time. The aim of this study is to examine factors influencing trajectories of poker players. The results are based on data collected at a four-time measurement of a prospective cohort study conducted in Quebec (n = 304 poker players). A latent class growth analysis was performed to identify trajectories based on the Problem Gambling Severity Index score. Multinomial multivariable logistic regression analyses were conducted to determine the correlates of gambling trajectories. Over the 3 years of the study, three gambling problem trajectories were identified, comprising one decreasing trajectory (1st: non-problematic-diminishing), one stable trajectory (2nd: low risk-stable), and one increasing trajectory (3th: problem gamblers-increasing). Internet as the main poker form and number of game played were associated with at-risk trajectories. Depression symptoms were significant predictors of the third trajectory whereas impulsivity predicted the second trajectory. This study shows that the risk is remaining low over years for the vast majority of poker players. However, the vulnerable poker players at the beginning of the study remain on a problematic increasing trajectory. It is therefore important to prioritize individuals in the third trajectory for interventions.

Use of Self-control Strategies for Managing Gambling Habits Leads to Less Harm in Regular Gamblers.

There is little research on the control strategies used by the general public to self-manage gambling habits and avoid harmful consequences. The current study sought to identify the most common self-control strategies of people who gamble regularly, the characteristics of those who use them, and assess the effectiveness of limit-setting strategies in reducing gambling-related harm. We recruited a large sample (N = 10,054) of Canadian adults who reported gambling activity in the past 12 months. Participants completed a survey that assessed gambling habits, use of control strategies including quantitative limit setting, and gambling related harm. The most common control strategies were setting predetermined spending limits, tracking money spent, and limiting alcohol consumption. The number of self-control strategies used by gamblers was positively associated with gambling involvement, annual income, problem gambling severity and playing electronic gaming machines. Approximately 45% of respondents failed to adhere to self-determined quantitative limits for spending, frequency, and time spent gambling. People who stayed within their gambling limits were less likely to report harm even after controlling for other risk factors. However, the effectiveness of remaining within one's personal spending limit decreased for those whose limits exceed $200CAN monthly. The findings support public health interventions that promote lower-risk gambling guidelines aimed at helping gamblers stay within spending, frequency and duration limits.

[Clinical profile of adolescents being treated for problematic internet use]. / Portrait Clinique des Adolescents en Traitement Pour une Utilisation Problématique d'Internet.

OBJECTIVES: This study highlights the clinical profile of adolescents having consulted with an addiction treatment center (ATC) in Québec for a problematic internet use (PIU) to develop knowledge about these specific clients and precisely target their needs relative to treatment. METHOD: The study was conducted with 80 adolescents between ages 14 and 17 (M = 15.59) who had consulted with an ACT for a PIU. Adolescents have participated in an interview documenting internet use patterns and their consequences, mental health disorder co-occurrence, and family and social relationships. RESULTS: The sample was constituted of 75 boys (93.8%) and 5 girls (6.3%), who spent an average of 55.8 hours (SD = 27.22) per week on internet for non-school or professional activities. Almost all of these youths (97.5%) presented a co-occurring mental health disorder, and more than 70% had seeked help last year for a psychological problem. Results show that 92.6% feel their internet use significantly hinders their family relationships, and 50% feel it impedes their social relationships. CONCLUSIONS: This study shows the multiple difficulties experienced by adolescents in need of a treatment for their PIU. The presence of co-occurring mental health disorders and relational difficulties among them underlines the need to develop and implement in ACTs integrated assessments and treatments that target not only online activities, but also all of life domains that can be affected by PIU. CLINICAL IMPLICATIONS: - PIU adolescents are mainly boys who report problematic use of video games. - Almost all young people who consult for PIU have comorbid mental health problems and difficulties in their relation. - The study highlights the need to offer to this clientele an integrated assessment and treatment services that target all areas of their lives who are likely to be affected, to contribute or maintain the PIU. LIMITATIONS: - This study was conducted with a convenience sample and the results are representative of young people who have visited a treatment center for addiction. The generalization of results to all adolescents with PIU is limited. - Considering that PIU are subject to cultural influence, the scope of this study is limited to populations living in a culture similar to that of Quebec and Canada.

OBJECTIFS: La présente étude dresse le profil clinique des adolescents ayant consulté un centre de traitement de la dépendance (CTD) au Québec en raison d'une utilisation problématique d'Internet (UPI) afin de développer les connaissances sur cette clientèle spécifique et de cibler avec justesse leurs besoins par rapport au traitement. MÉTHODE: L'étude est réalisée auprès de 80 adolescents âgés entre 14 et 17 ans (M = 15,59) ayant consulté un CTD pour une UPI. Les adolescents ont pris part à une entrevue qui documente les habitudes d'utilisation d'Internet et leurs conséquences, la concomitance de troubles de santé mentale, ainsi que les relations familiales et sociales. RÉSULTATS: L'échantillon est composé de 75 garçons (93,8%) et de 5 filles (6,3%), qui passaient en moyenne 55,8 heures (ET = 27,22) par semaine sur Internet pour des activités non-scolaires ou professionnelle. Près de la totalité de ces jeunes (97,5%) présente un trouble de santé mentale en concomitance et plus de 70% ont consulté dans la dernière année pour un problème psychologique. Les résultats indiquent que 92,6% estiment que leur utilisation d'internet nuit significativement à leur relation familiale et 50% à leurs relations sociales. CONCLUSIONS: Cette étude révèle les nombreuses difficultés vécues par les adolescents requérants un traitement pour leur UPI. La présence de troubles de santé mentale concomitants et de difficultés relationnelles chez ceux-ci renvoie à la nécessité de développer et implanter dans les CTD des évaluations et traitements intégrés qui ciblent non seulement les activités en ligne, mais également l'ensemble des sphères de vie pouvant être affectée par l'UPI. IMPLICATIONS CLINIQUES: ­ Les adolescents consultants pour l'UPI sont principalement des garçons qui rapportent une utilisation problématique des jeux vidéo. ­ La quasi-totalité des jeunes qui consultent pour l'UPI a en concomitance de problèmes de santé mentale et des difficultés sur le plan relationnel ­ L'étude met en évidence la nécessité d'offrir à cette clientèle des services d'évaluation et de traitement intégrés qui ciblent toutes les sphères de leur vie sont susceptibles d'être affectée, de contribuer ou de maintenir l'UPI. LIMITES: ­ Cette étude est réalisée auprès d'un échantillon de convenance et les résultats sont représentatifs des jeunes ayant consulté un centre de traitement pour la dépendance; la généralisation des résultats à l'ensemble des adolescents présentant une UPI est limitée. ­ Considérant que les manifestations de l'UPI sont sujettes à une influence culturelle, la portée de la présente étude se limite aux populations qui vivent dans une culture similaire à celle du Québec et du Canada.

Transdermal alcohol monitoring combined with contingency management for driving while impaired offenders: A pilot randomized controlled study.

OBJECTIVES: In a pilot randomized controlled trial of contingency management (CM) and transdermal alcohol monitoring (TAM) with offenders driving while impaired by alcohol (DWI), perceptions regarding the acceptability of a TAM device, recruitment issues, and the impact of CM and TAM on alcohol use over a 6-week period were evaluated. The results aimed to inform the design of future trials and programs involving CM and TAM for DWI remediation. METHODS: TAM devices were affixed to 37 voluntary, community-recruited male DWI offenders with problem alcohol use. They were randomized to one of 3 groups: (1) CM; (2) alcohol use feedback (FB); and (3) TAM device only (CTL). Quantitative and qualitative data were gathered on the acceptability of TAM devices and recruitment, and alcohol use was monitored via TAM and self-report. RESULTS: The TAM device was perceived positively, with benefits for reducing drinking noted. Nevertheless, some of its inconveniences appeared to influence participant recruitment and attrition, including its large size and limited water resistance. TAM data revealed a significant main effect of time for reduction in weekly peak transdermal alcohol concentration (P = .02), with a decrease between means of weeks 1 and 6 (M  =  0.15, SE = 0.02 vs. M = 0.09, SE = 0.02; P = .005). No significant group effect was detected. CONCLUSIONS: TAM is a viable adjunct to CM with DWI offenders, though the TAM device used here may influence both study recruitment and adherence. These findings can guide the design of future studies into CM and TAM for DWI remediation.

Canadian drivers' attitudes regarding preventative responses to driving while impaired by alcohol.

BACKGROUND: In many jurisdictions, a risk assessment following a first driving while impaired (DWI) offence is used to guide administrative decision making regarding driver relicensing. Decision error in this process has important consequences for public security on one hand, and the social and economic well being of drivers on the other. Decision theory posits that consideration of the costs and benefits of decision error is needed, and in the public health context, this should include community attitudes. The objective of the present study was to clarify whether Canadians prefer decision error that: i) better protects the public (i.e., false positives); or ii) better protects the offender (i.e., false negatives). METHODS: A random sample of male and female adult drivers (N=1213) from the five most populated regions of Canada was surveyed on drivers' preference for a protection of the public approach versus a protection of DWI drivers approach in resolving assessment decision error, and the relative value (i.e., value ratio) they imparted to both approaches. The role of region, sex and age on drivers' value ratio were also appraised. RESULTS: Seventy percent of Canadian drivers preferred a protection of the public from DWI approach, with the overall relative ratio given to this preference, compared to the alternative protection of the driver approach, being 3:1. Females expressed a significantly higher value ratio (M=3.4, SD=3.5) than males (M=3.0, SD=3.4), p<0.05. Regression analysis showed that both days of alcohol use in the past 30days (CI for B: -0.07, -0.02) and frequency of driving over legal BAC limits in the past year (CI for B=-0.19, -0.01) were significantly but modestly related to lower value ratios, R2(adj.)=0.014, p<0.001. Regional differences were also detected. CONCLUSIONS: Canadian drivers strongly favour a protection of the public approach to dealing with uncertainty in assessment, even at the risk of false positives. Accounting for community attitudes concerning DWI prevention and the individual differences that influence them could contribute to more informed, coherent and effective regional policies and prevention program development.

Life events and problem gambling severity: A prospective study of adult gamblers.

Several studies have shown that gambling problems are cyclical but few have empirically investigated factors that are associated with change. The purpose of this article is to prospectively examine associations between life events and problem gambling severity in a cohort of gamblers. Occurrence of life events and gambling problem severity were assessed 3 times over a period of 2 years in a cohort of nonproblem and problem gamblers (N = 179) drawn from a representative sample derived from a population survey. Cross-lagged analyses revealed that cumulative number of life events were associated with an increase in severity of problem gambling 12 months later. Regression analyses showed that significant life events in several domains, for example, "change in sleeping habits," "accidental injury or illness" or "retirement," are likely to be associated over time to the increase or the continuation of risky gambling habits. This study's findings on the potential negative influence of cumulative number of life events, or of specific ones, are informative for secondary prevention and treatment. (PsycINFO Database Record

A cross-cultural comparison of population gambling patterns and regulatory frameworks: France and Québec.

Few empirical studies have examined the relationships between differing regulatory approaches and patterns of gambling behaviors. This article reports on a correlational cross-cultural comparison of differences in the regulatory approaches and gambling behavior among general adult populations in France and Québec, Canada. We drew data from two large population surveys conducted in France and Québec (N=27 653 and N=11 888, respectively). We found diverging and converging aspects of government regulatory policies. Statistical analyses demonstrated significantly higher participation rates and prevalence of 'assiduous gamblers' in Québec. In France, among assiduous gamblers, the proportion of moderate-risk and probable pathological gamblers is significantly higher. Future research should examine environmental conditions and varying gambling offerings, as well as gambling regulation, to determine their potential influence on gambling behaviors.

Examining cortical thickness in male and female DWI offenders.

Some sex differences have been detected in driving while impaired by alcohol (DWI) offenders. However, understanding of the key factors contributing to DWI among male and female drivers remains elusive, limiting development of targeted interventions. Sex-based neurocognitive analyses could provide the much-needed insight. We examined whether male DWI offenders show cortical thickness anomalies that differ from those in female DWI offenders, when compared to their respective controls. Moderating role of sex and alcohol use on DWI status was also investigated. Sixty-one DWI offenders (29 male; 32 female) and 58 controls (29 male; 29 female) completed an anatomical brain scan and assessments on other relevant characteristics. Only male DWI offenders had reduced cortical thickness in the right dorsal posterior cingulate cortex (PCC), a region involved in cognitive control. Lower cortical thickness was associated with increased odds of DWI status only among males who have not engaged in very hazardous pattern of alcohol misuse in the previous 12 months. Thus, for these male DWI drivers, interventions that could impact PCC could be most advantageous. Continued multidimensional sex analysis of the neural characteristics of male and female DWI offenders is warranted.

Personality, Executive Control, and Neurobiological Characteristics Associated with Different Forms of Risky Driving.

BACKGROUND: Road crashes represent a huge burden on global health. Some drivers are prone to repeated episodes of risky driving (RD) and are over-represented in crashes and related morbidity. However, their characteristics are heterogeneous, hampering development of targeted intervention strategies. This study hypothesized that distinct personality, cognitive, and neurobiological processes are associated with the type of RD behaviours these drivers predominantly engage in. METHODS: Four age-matched groups of adult (19-39 years) males were recruited: 1) driving while impaired recidivists (DWI, n = 36); 2) non-alcohol reckless drivers (SPEED, n = 28); 3) drivers with a mixed RD profile (MIXED, n = 27); and 4) low-risk control drivers (CTL, n = 47). Their sociodemographic, criminal history, driving behaviour (by questionnaire and simulation performance), personality (Big Five traits, impulsivity, reward sensitivity), cognitive (disinhibition, decision making, behavioural risk taking), and neurobiological (cortisol stress response) characteristics were gathered and contrasted. RESULTS: Compared to controls, group SPEED showed greater sensation seeking, disinhibition, disadvantageous decision making, and risk taking. Group MIXED exhibited more substance misuse, and antisocial, sensation seeking and reward sensitive personality features. Group DWI showed greater disinhibition and more severe alcohol misuse, and compared to the other RD groups, the lowest level of risk taking when sober. All RD groups exhibited less cortisol increase in response to stress compared to controls. DISCUSSION: Each RD group exhibited a distinct personality and cognitive profile, which was consistent with stimulation seeking in group SPEED, fearlessness in group MIXED, and poor behavioural regulation associated with alcohol in group DWI. As these group differences were uniformly accompanied by blunted cortisol stress responses, they may reflect the disparate behavioural consequences of dysregulation of the stress system. In sum, RD preference appears to be a useful marker for clarifying explanatory pathways to risky driving, and for research into developing more personalized prevention efforts.

The dilemma of re-licensing DWI offenders: The offenders' point of view.

In many jurisdictions, drivers convicted for the first-time of driving while impaired by alcohol undertake a risk assessment that will determine the severity of sanctions and the remedial measures they must follow as requisites for re-licensing. There is uncertainty inherent in the assessment of risk for recidivism, however, many offenders feel unfairly assessed and discommoded by the decision-making process and its consequences. The objective of this qualitative study was to gain insight into the perspectives of offenders regarding re-licensing decision making and sanctioning. Specifically, in focus groups first-time offenders and recidivists were probed as to whether they favoured erring on the side of road safety in decision making, with its consequent greater risk of false positive assessments, or erring on the side of maintaining driving privileges, with its consequent greater risk of false negative assessments. In general, participants preferred a higher probability of false negative vs. false positive assessments. Most cited the consequences of sanctions and remedial measures as too severe to impose them on potentially low-risk drivers, as the assessment and monitoring protocols' limitations could lead to non-equitable treatment. At the same time, recidivists evoked a greater preference for a higher probability of false positive assessments compared to first-time offenders, as they believed that recidivism was more likely to follow a first conviction than did first-time offenders. This information can be useful for a more comprehensive and societally coherent exercise of DWI prevention policies.

Sex Differences in the Personality and Cognitive Characteristics of First-Time DWI Offenders.

OBJECTIVE: Driving while impaired by alcohol (DWI) is a significant yet preventable public health problem. The overrepresentation of males among DWI offenders has been attributed in part to greater sensation seeking and impulsivity features in males, although recent evidence points to increasing female DWI events. Studies exploring sex differences in DWI to better understand and intervene in these trends are rare and often methodologically lacking. This study examined sex differences among first-time DWI offenders by testing the hypotheses that, compared with non-DWI drivers, male offending is primarily associated with greater impulsive and sensation-seeking personality features and response disinhibition, whereas female offending is primarily associated with greater alcohol misuse. METHOD: Male and female drivers ages 18-44 years convicted of a first DWI offense (n = 217) and non-DWI driver controls (n = 79) were recruited and compared on measures of psychosocial characteristics, substance use, personality, and response inhibition. RESULTS: In partial support of our hypotheses, greater alcohol misuse severity was found in female DWI offenders compared with female non-DWI drivers but an equivalent effect was not detected in males. Counter to hypothesis, greater impulsivity, sensation seeking, and response disinhibition were not found in male non-DWI drivers compared with male non-DWI drivers. Unexpectedly, greater impulsivity was found in female DWI offenders compared with female DWI drivers. CONCLUSIONS: Little evidence was found for impulsivity, sensation seeking, and response disinhibition being factors that directly explain higher rates of DWI offending in males. In contrast, more marked alcohol misuse and trait impulsivity in female DWI drivers suggest a greater vulnerability to uncontrolled drinking leading to dangerous driving. These findings represent a basis for examining sex-related responsivity to distinct approaches to DWI prevention.

Patterns and trends in gambling participation in the Quebec population between 2009 and 2012.

OBJECTIVES: To describe gambling practices and trends in Quebec between 2009 and 2012 given that, in Canada, public funding allocation to address the risks associated with gambling practices should be based on valid prevalence data and knowledge of patterns and trends in vulnerable populations. METHODS: The study data were taken from the 2009 and 2012 cross-sectional waves of the Enquête sur les habitudes de jeu des Québécois (ENHJEU-Québec). The analytical sample consisted of 11,888 respondents in 2009 and 12,008 respondents in 2012. RESULTS: The prevalence of lifetime non-gamblers in the adult population of Quebec increased from 13.6% in 2009 to 16.4% in 2012, and past-year gambling participation decreased from 70.5% to 66.2%. Changes in gambling patterns were not contingent on demographic characteristics; gambling prevalence decreased in all subcategories. The proportion of problem and low-risk gamblers remained unchanged, whereas the prevalence of non-problem gamblers decreased significantly from 66.1% in 2009 to 61.5% in 2012. CONCLUSION: Gambling participation in Quebec is decreasing, though the proportion of problem gamblers remains stable. Given these findings, allocation of public resources for health care services should be maintained. Secondary and primary prevention efforts need to be initiated or maintained to prevent gambling harm.

Comparing problem gamblers with moderate-risk gamblers in a sample of university students.

BACKGROUND AND AIMS: In an effort to provide further empirical evidence of meaningful differences, this study explores, in a student population, the distinctions in gambling behavioral patterns and specific associated problems of two levels of gambling severity by comparing problem gamblers (PG) and moderate-risk gamblers (MR) as defined by the score on the Problem Gambling Severity Index (PGSI; MR: 3-7; PG: 8 and more). METHODS: The study sample included 2,139 undergraduate students (male = 800, mean age = 22.6) who completed the PGSI and questionnaires on associated problems. RESULTS: Results show that problem gamblers engage massively and more diversely in gambling activities, more often and in a greater variety of locations, than moderate-risk gamblers. In addition, important differences have been observed between moderate-risk and problem gamblers in terms of expenditures and accumulated debt. In regards to the associated problems, compared to moderate-risk gamblers, problem gamblers had an increased reported psychological distress, daily smoking, and possible alcohol dependence. DISCUSSION AND CONCLUSIONS: The severity of gambling and associated problems found in problem gamblers is significantly different from moderate-risk gamblers, when examined in a student population, to reiterate caution against the amalgamation of these groups in future research.