Kelly told me that the lack of actionable, evidence-based guidance on how to treat youth gambling keeps him up at night, because multiple studies have found a link between suicide, suicidal ideation and gambling disorder. “We need to be doing something and evaluating efficacy so that we are in a position to actually deal with this problem, rather than waiting for the wave of young male suicides,” Kelly told me. (While young men are more likely to gamble than young women, women may progress to problem gambling faster than men do.)
Lia Nower, the director of the Center for Gambling Studies at the Rutgers School of Social Work, is at the forefront of the kind of research that Kelly would like to apply in his practice. She told me that because of the lack of organized governmental or private funding for research into gambling, “a lot of what we want to know, we can’t answer.” Like Kelly, she said that she’s seeing gambling issues begin in elementary school.
Nower and her colleagues found that if other family or household members gamble, that is a risk factor for kids becoming problem gamblers, and that many parents are unaware that gambling in front of their kids is bad. According to a Common Sense Media survey, over half of boys who have gambled in the past year did so with family members. She believes we’re currently thinking about gambling the way we thought about cigarettes and alcohol in the mid-20th century, when these substances were treated as benign, many more smoked, and “everybody had a bar in their office and no one thought anything about driving drunk or driving their kids around in the car while they were drunk.”
Still, researchers have started to develop frameworks and theories for identifying problem gamblers and treating them. There is a widely used screening test called the Problem Gambling Severity Index — but scoring high on that index tells us only so much about what’s behind a person’s excessive gambling or how to ameliorate it. Nower and her colleagues, based on their clinical experience, have identified three different subtypes of problem gambling.
People in the first and largest group, the “behaviorally conditioned,” have no other significant emotional problems and develop issues with gambling because they are exposed to it through socialization. Everyone is doing it, so they do it, and then they start chasing their losses. Those in the second group, the “emotionally vulnerable,” are more likely to struggle with depression and anxiety and to have had adverse childhood experiences. The third group, “antisocial impulsivist,” is somewhat self-explanatory: Its members are antisocial and impulsive, and they’re also more likely to engage in risky sexual behavior and substance use.
