The concept of vulnerability and gambling-related harm : Gambling Regulation and Vulnerability

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Gambling definition

Chapter 1: The concept of vulnerability and gambling-related harm


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Gambling definition lunge

Postby Kamuro В» 18.01.2020

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Download PDF The conceptualisation of gambling-related harm is saliently driven by whether gambling is regulated from the perspective of public health or from the paradigm of economic considerations. The scope of what consequences are attributed to gambling and how they are measured determines how those issues are treated within any given jurisdictions and to what extent they are regulated.

The vast majority of individuals are able to live around and even participate in gambling and gambling-type activities without suffering any negative long- or short-term consequences. Unlike smoking, which has been recognised to cause some harm with even only one cigarette, 1 gambling participation may constitute an exciting and harmless entertainment that may even enhance the personal well-being of those who enjoy it.

Bingo in particular has been claimed to help with the improvement of concentration and short-term memory. Yet, for some people gambling becomes a dangerous pastime that leads to severe negative outcomes. On a micro level, problems with gambling affect the individuals themselves but the impact almost invariably extends to their immediate family and close social circles. This, in turn, affects society as a whole on a macro level by raising the cost of public spending.

Such an increase may be required in terms of welfare benefits if breadwinners lose their jobs and are unable to provide for their families; to provide treatment for affected individuals and their relatives, or in more intangible ways, such as due to lost productivity, 5 less willingness to give to charitable causes or the necessity to deal with potentially increased crime levels.

Why some people develop gambling-related problems and others do not remains disputed. It would be simple to blame the affected individuals for their inability to control their behaviour. Its use is so embedded within the literature that barely anyone considers its impact but it subconsciously perpetuates the perception that gambling disorder occurs primarily due to the irresponsibility of the individual concerned.

Indeed, the general population still attaches stigma to those who are unable to restrain themselves, and some perceive problem gamblers as people who are less intelligent or simply incapable of rational thinking. Some people often continue to blame themselves and fail to seek treatment out of embarrassment or fear of admitting to having a mental health issue. But none of these factors alone is responsible for gambling disorders, which are caused by the combination of a multitude of factors that mix personal, structural, situational and environmental agents.

It also frames gambling-related detriment narrowly, which leads to the overall underestimation of the extent of related harm, and results in a biased cost—benefit analysis. But it is this choice that dictates the extent and manner to which vulnerable persons are protected and determines the overall scope of the regulatory interventions.

While nobody would dispute the need for policy making to be underpinned by robust empirical evidence, the research that is commissioned to produce such evidence must encompass a broad understanding of vulnerability and harm.

This has not been ensured and the research agenda continues to focus on individual risk factors. This perpetuates the desirable political construct but neglects to recognise the complexity and nuanced nature of the discourse. The majority of jurisdictions that legalise gambling often refer to vulnerability and gambling-related harm within the legislation, but leave their meaning largely undefined.

Only a small number of definitive statements are provided, and the overall scope of both terms is left to be determined by the regulatory bodies with the responsibility of minimising such harm and protecting those who may be vulnerable to it. The UK Gambling Act follows the same pattern. Section 1 of the Act sets out the overriding licensing aims that underpin the statutory regime. This position follows a typical legislative paradigm and is, in principle, beneficial.

It allows the regulatory framework to be more responsive to changes in a political environment as well as to react to new empirical data that may become available without necessitating statutory intervention.

It allows for the scope of the relevant terms to be determined and adjusted in accordance with the latest scientific and psychological knowledge. However, within the gambling context, this approach suffers from many disadvantages. Empirical evidence remains inconclusive and is limited. It is primarily based on short-term and medium-term studies, and there is a relative paucity of longitudinal research. Lack of agreed categorisation of what is meant by gambling-related harm leads to substantial inconsistencies within the literature that deals with supposedly the same phenomenon.

This results in the same terminology being used interchangeably to describe different experiences, and at the same time different terms are often used in discourses that address the same concepts.

Secondly, lack of statutory direction allows the narrowing down of the range of experiences deemed sufficiently serious to be afforded attention to a gambling disorder, with other forms of harms being unconsciously marginalised. Levels of gambling disorders are identified and measured by national prevalence surveys, and results from these are used to demonstrate the effectiveness of the UK regulatory regime.

The headline figures compare levels of problem gambling before and after liberalisation. They demonstrate only negligible fluctuations, 13 and some even suggest that instances of gambling harm have declined since the industry was liberalised.

Similarly, comparisons made between jurisdictions with open gambling markets and those that aim to restrict or suppress gambling seem to indicate that levels of problem gambling are similar in both. However, this fails to recognise that a gambling disorder at the end of the spectrum is not, and should not be treated as, an exhaustive indicator of gambling harm. Similar difficulties are also pervasive in the context of the categorisation of which groups in society, if any, are vulnerable.

Most regulators, in their official rhetoric, imply that they adopt a wide and expansive interpretation, but this does not necessarily translate into any specific actions. Preventative measures of any substance are typically confined to minors and those who already suffer from an inability to control their gambling behaviour.

This undermines the statements that vulnerability is treated holistically and indeed points in the opposite direction when substantive actions and regulatory responses are considered. Existing initiatives are also, for the most part, confined to enabling individuals to control their behaviour, and little attention is given to the second dimension of the causes of vulnerability, directly referring to the safety or addictiveness of the gambling products themselves.

Each gambling form has a different level of risk but none is entirely risk-free. Accordingly, this chapter considers the interrelationship between the vulnerability of individuals and the structural and psychosocial features of the gambling products. It demonstrates that existing conceptualisations of gambling harm and vulnerability are too narrow. This leads to many gambling-harm prevention initiatives being designed, but, in substance, they focus on the general gambling public rather than the target group of those who are or may find themselves vulnerable.

In principle, this may appear to be the correct approach. However, it ignores the fact that the majority of people are able to adapt their behaviour in response to legislative changes and are capable of protecting themselves. Gambling-related harm can be conceptualised in a variety of ways. Each leads to different priorities in preventative and treatment strategies incorporated into the regulatory framework.

Very few jurisdictions have attempted to offer a statutory definition of the term. However, statutory definitions are not replicated in other jurisdictions, including the UK. This leads to greater emphasis being placed on the medical harm that gambling may cause. The reference to pathological gambling was removed and the name of the condition was changed to a gambling disorder. The change in the terminology was driven by the desire to remove the stigma that typically affects those who do not control their gambling behaviour and to emphasise that this is indeed a psychological illness.

DSM-V also reclassified gambling disorder and moved it from the category of impulse control disorders into substance addictions. This was done in recognition of the existing medical knowledge that demonstrates that the behavioural and neurological brain responses of affected individuals correspond more to substance addictions than to impulse control impairments, even though no actual substance is consumed or inhaled.

Gambling disorder is measured by the DSM-V screening test. Under this test, individuals will be deemed to be affected by the illness if they endorse four or more criteria from the list of nine in the month period preceding the test, unless a diagnosis of a Manic Episode more accurately reflects the actual behaviour.

DSM-V screening test is not the only measure that has been developed and validated for this purpose. Indeed, the DSM-V test is still relatively new and many jurisdictions continue to refer to the previous DSM-IV criteria in their public health surveys or population-based studies. Some, such as for example DSM-IV, focus primarily on establishing the existence or absence of a disorder with two potential stages that operate on a continuum basis.

A diagnosis of problem gambling would be reached if the affected person endorsed three or more of the listed criteria, while a diagnosis of probable pathological gambling would typically be made if five or more of the criteria are met.

While this recognises the illness, it does not reflect on the journey that affected gamblers undertake before they reach the first stage of the medical condition. This, in turn, gives only a token recognition to the fact that interim forms of gambling harm may be equally acute even though they do not manifest themselves in an actual disease.

While some researchers caution against including minor types of harm that may be experienced by low-risk gamblers within the overall aggregates, 21 the progressive nature of gambling disorder means that symptoms may develop over a longer period of time and the trigger points that cause gamblers to cross the line between low-risk gambling and problem gambling are not being identified.

Alternatively, it has been equally recognised that gamblers may assert five or more of the criteria and yet not truly suffer complete loss of their gambling control or any gambling-related harm. This test not only measures the rates of mental disorder but can also identify those individuals who are at either low or moderate risk of developing such a disorder. However, none of the test is able to determine when and why low or moderate risk gamblers become problem gamblers. The latest levels of problem gambling as reported by the survey for England, the survey for Scotland and the survey for Wales were reported to be low.

Amongst the overall English population aged 16 years and above 0. The PGSI problem gambling scores that identified the rates of those who are at either moderate or low risk of developing gambling problems are shown in Tables 1. The overall levels of problem and at-risk gambling, as reported by the surveys, appear be declining in comparison to rates recorded in the surveys that were carried out before or shortly after the liberalising effect of the Gambling Act came into force.

However, comparisons with previous years must be treated with caution. The methodology of the surveys has materially changed at critical points in time. This renders any claims that liberalisation did not affect problem gambling or that it actually helped to reduce the extent unreliable. Prior to the enactment of the Act and shortly after, the data was collected using British Gambling Prevalence Surveys 27 that targeted gamblers to obtain their insights into gambling behaviours and attitudes.

However, after the collection of gambling prevalence data via bespoke national gambling surveys was discontinued and replaced with sections incorporated into the wider Health Surveys for England and Scotland and the Welsh Problem Gambling Surveys.

This change of data collection method is not without its consequences. Different screening measures produce different estimates, but this equally applies to different vehicles as each will capture varying groups of individuals. Their findings are reported in different years, refer to different cohorts of surveyed individuals and they do not even employ the same reporting methodology.

This makes it very difficult to analyse the findings at a national level and to compare it with previous years. Table 1. Similar patterns can be seen in the context of children. The majority of screening tests were developed with the intention of using them to diagnose adults and their unsuitability for use with minors was quickly established. Under the modified version, a minor would be classified as a pathological gambler if he or she endorsed four or more of the criteria from the following list:.

There are also other screens that were developed specifically for the use with minors but they are all modelled on their adult equivalents. In the United Kingdom, the rates of pathological gambling and at-risk gambling amongst children up to the age of 16 years old are measured by a research study referred to in this book as Young People Omnibus. It is the sole study that is carried out in schools on a recurring basis that collects data reflecting the variety of behaviours and opinions of a statistically representative sample of children aged between 11 and 16 years old.

The main findings identified the proportion of children aged between 11 and 16 years old who gambled in the seven days preceding the survey; the rates of problem gambling; the profile of those who are engaged in gambling; the most popular forms of gambling and how children purchase lottery tickets despite them not being legally allowed to play. The latest findings indicated that 0. Similarly to the adult surveys, these headline figures seem very optimistic as they appear to indicate that the rates of problem and at-risk gambling have substantially fallen, despite the significant increase in gambling opportunities that have occurred since The adoption of a different test already, by itself, prevents reliable comparisons.

This choice was surprising. Reliable evidence pointed out that DSM-IV criteria substantially underestimated problem gambling prevalence rates, even when the test was used with adults as intended but outside clinical settings. Indeed, Pelletier et al. Moreover, the overall reliability of any of the gambling screening measures is not without its own controversies.

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