Problem Gambling Among Adolescents

When parents think of the behavioral, mental health, or emotional disorders their children might experience or develop during adolescence, a gambling addiction or disorder typically isn’t at the top of their what should I worry about? checklist.

During this pandemic era, most parents have their attention on the mental health issues adolescent development experts warned them about back in March 2020. They look for signs of depression, anxiety, grief, and new or increasing alcohol or drug use. They look for issues at school like conduct disorder or oppositional defiant disorder.

Gambling?

That’s not a problem that’s on many parents’ radar screens.

However, problem gambling among teens is a bigger issue that most parents think, and it can lead to some of the same long-term negative consequences associated with most significant mental health disorders, including depression, anxiety, and alcohol or substance use disorder.

Data from the International Center for Youth Gambling Problems and High-Risk Behaviors at McGill University indicates the following:

• About 4-5% of adolescents age 12-17 meet one or more criteria for problem gambling, a.k.a. gambling addiction, clinically knows as gambling disorder (GD)
• 10-14% are at risk of developing gambling disorder
• 60-80% of teens report gambling for fun in the past year
• Boys gamble more often, and are at higher risk of developing GD than girls

Mental health and addiction experts define problem gambling as:

“…gambling that results in adverse consequences for individuals, families and communities.”

The adverse consequences associated with problem gambling may include:

• Impaired mental health
• Physical health
• Relationship dysfunction
• Family dysfunction
• Financial problems
• Employment difficulties
• Legal issues

Those are serious consequences and high prevalence rates for what most parents consider a non-issue for teens. Let’s take a look at the details on this issue, starting with the difference between harmless gambling and gambling that might be problematic.

Harmless Wager or Problem Gambling: What’s the Difference?

For this article, we’ll use data from a peer reviewed journal article called “Problem Gambling In Adolescents: What Are The Psychological, Social And Financial Consequences?,” and information from a website with an excellent section on teen gambling called TeenHelp.

We’ll start with an overview of teen gambling behavior, then move on to a more clinical discussion of the risk factors, protective factors, associated mental health disorders, and the available evidence-based treatments for gambling disorder.

According to TeenHelp, gambling among adolescents appears in two forms: social gambling and pathological gambling.

Social Gamblers

Social gamblers…

• Start with a specific amount of money and stop when they run out. They don’t get into informal credit, IOUs, or any similar method of extending the gambling in the moment
• Don’t really do it for the money. They do it for the fun of the game.
• Don’t get involved in games that involve large amounts of money
• May play regularly, but only one or two times a week, and only gamble with friends

Pathological Gamblers

Pathological gamblers…

• Report that they enjoy the feeling the get from gambling, and describe it as a “rush”
• Try to keep playing when they run out of money, by using informal credit or IOUs
• Go to great lengths to keep gambling once they start
• Persist in playing even when losing consistently, in search of a big win
• Will gamble online and put bets on credit without thinking it through

Parents who think their teen may be on the verge of developing a gambling disorder can watch out for specific signs.

Problem Teen Gambling: Red Flags

• Selling personal possessions
• Asking for loans from friends and family, but never repaying those loans
• Stealing money and lying about it
• Possessing large amounts of cash with no reasonable explanation
• Accruing large amounts of debt with no reasonable explanation
• Receiving phone calls from stranger – often
• Withdrawing from friends, social groups, and social activities
• Calling gambling numbers – with the 900 prefix – with increasing frequency
• Acting distracted, anxious, moody and/ depressed.
• Missing school or work with no explanation
• Coming home late, past curfew, frequently, with no reasonable explanation
• Spending time – hours and hours – playing on online gambling sites
• Obsession with sports scores can indicate a sports gambling habit.

Parents reading this probably understand where we’re going with this data: pathological, problem gambling appears similar to other addictions, such as to alcohol or drugs. That’s one reason we’re writing this article. When a teen develops an addiction disorder, it’s often the result of self-medication, which is the practice of using certain types of behavior to relieve the uncomfortable feelings associated with underlying mental health disorders such as depression or anxiety. Most people know about self-medication with intoxicants. Self-medication with a behavior like gambling functions in the same way.

That brings us into the clinical section of this article. Next, let’s take a look at the criteria a psychiatrist, therapist, or other mental health professional might use to diagnose problem gambling in an adolescent.

Problem Gambling: Clinical Criteria

The peer-reviewed journal article we introduce above presents the following criteria for problem gambling. If an individual displays (4) or more of these behaviors in a 12-month period, they meet the clinical criteria for a gambling disorder:

1. The need to gamble with more money each time to get the same feeling of excitement
2. Restlessness, anger, or irritability when trying to stop or limit gambling
3. Tries without success to stop, control, or limit gambling
4. Preoccupation with gambling:

• • • Persistent thoughts of gambling experiences
    • Reliving gambling experiences
    • Planning the next gambling episode
    • Planning ways to get money to gamble

5. Gambles when under emotional duress, e.g. when feeling:

• • • Helpless
    • Guilty
    • Anxious
    • Depressed

6. Returns to the game after losing, called chasing the losses
7. Lies about how much they gamble
8. Loses or jeopardizes the following due to gambling:
   • • Relationships
     • Jobs
     • Educational opportunities
     • Career opportunities
9. Relies on family or friends to solve financial problems caused by gambling

Gambling disorders can be mild, moderate, or severe:

Mild:

An individual who meets 4-5 of the criteria above may have a mild gambling disorder

Moderate:

An individual who meets 6-7 of the criteria above may have a moderate gambling disorder

Severe:

An individual who meets 8-9 of the criteria above may have a severe gambling disorder

Parents of adolescents should understand another thing: one of the developmental characteristics of adolescence – risk-taking/novelty seeking – makes them more vulnerable to gambling itself. That’s why this next statistic may simultaneously surprise you and sound logical: the prevalence of problem gambling among adults is around 1-2 percent of the population. Compare that to the 4-5% of teens who meet criteria for gambling disorder, and it’s clear that this is an important topic for parents to know about.

Not only does gambling lead to negative emotional, social, and psychological consequences, it also has a negative impact on the form and function of that same brain area directly involved in alcohol and drug addiction: the reward system.

With these facts in mind, let’s look at the known risk factors for problem gambling.

Problem Teen Gambling: Who’s at Risk?

Evidence from various studies – including the Problem Gambling in Adolescence article we cite above – shows a set of factors common among people who engage in problem gambling. These are called risk factors. We collated the following set of risk factors from the articles we discuss above and the Mayo Clinic webpage on problem gambling:

Mental Health Disorders

Problem gambling is associated with:

• Substance use disorder
• Alcohol use disorder
• Personality disorders
• Depressive disorder
• Anxiety disorders
• Bipolar disorder
• Obsessive-compulsive disorder (OCD)
• Attention-deficit/hyperactivity disorder (ADHD)

Age

Compared to the general population, problem gambling and gambling disorder are most common among:

• Young people, including:
  • Adolescents (12-17)
  • Young adults (18-23)
• Older adults 65+

Initiating gambling during childhood or adolescence increase risk of developing gambling disorder.

Gender

• Males develop gambling disorder at three times the rate as females
  • 1% of problem gamblers are male
  • 8% of problem gamblers are female

Family, Friends, and Peers

• Individuals with friends and family who gamble are more likely to become problem gamblers than those whose friends and family don’t gamble

Personality

The following personality types are associated with problem gambling:

• Competitive
• Impulsive
• Restless
• Temperamental
• Unpredictable
• Thrill seeking/sensation seeking

In this context, risk factor means two things. It means that research shows that teens who are problem gamblers are more likely to have those factors in their lives than teens who aren’t problem gamblers, and that teens for whom those factors are present are more likely to become problem gamblers than teens for whom they are not.

Now let’s look at protective factors, which are the opposite. The presence of these factors in a teen’s life decreases their risk of developing gambling disorder, and these factors are less likely to be present in the life of a teen with gambling disorder.

Teen Gambling: Protective Factors

• Female gender
• Presence of adaptive coping strategies
• Emotional intelligence
• Overall positive well-being
• Ability to self-monitor
• Personal/social competence
• Emotional/psychological resilience
• High interpersonal skills
• Positive social support
• Positive peer bonding
• School connectedness
• Moderate to high parental monitoring
• Positive family cohesion

Together, these risk and protective factors create a clear profile who’s most at risk of becoming a problem gambler: an impulsive teenage male, who may or may not have a mental health disorder, but likely has a thrill-seeking personality combined and low self-awareness and underdeveloped emotional regulation skills.

We recommend that parents of teenage boys who fit that profile and display the warning signs we share above take their teen to a licensed mental health professional for a full psychiatric evaluation. The evaluation may reveal a gambling disorder, and it may reveal emotional issues that contribute to the presence/development of a gambling disorder.

In either case, if a mental health professional diagnoses a mental health disorder, they’ll recommend a course of treatment. To learn about treatment for teen mental health disorders in general, click here. We’ll finish this article with a list of evidence-based treatment modalities proven effective for adolescent gambling disorder.

Treatment for Problem Teen Gambling

Before we discuss these treatment options, we need to address the elephant in the room. Actually, there are two: the law and the internet.

First, it’s illegal in almost all states for anyone under 21 to gamble. That’s true for in person gambling and online gambling. Which means that every teen we discuss above – in every sentence of this article – engages in illegal activity. While some states allow people age 18 and over to gamble, most don’t. Therefore, a teen who gambles risks not only emotional, social, and psychological consequences, but also legal consequences.

Second, online gambling. Access to the internet makes access to gambling sites easy for teens. Regulation is limited, and enforcement of age minimums is almost impossible – until a teen who gambles tries to cash out. At that point, they must prove they’re over 21 (or 18 in some states). If they can’t prove their age, they can’t collect their winnings. And if they use a false name, or solicit the help of an adult, that’s fraud, which means more legal trouble.

Parent of teen gamblers should tell their teens what we just wrote: it’s illegal and you can’t collect your money. Now, with that said, let’s move on to the type of therapy that can help teens who develop gambling disorder.

Evidence shows the following therapeutic approaches can help teens:

Therapy

Cognitive behavioral therapy (CBT): CBT helps teens identify life-interrupting patterns of thought and behavior and replace them and replacing them with life-affirming patterns of thought and behavior. That’s the root of CBT: connecting thoughts to behaviors and learning to modify behavior by first identifying the thoughts that lead to it.

Medication

Many teens with who develop gambling problems also have a depressive disorder or an anxiety disorder. In those cases, anti-depressant medication and anti-anxiety medication can also help decrease problem gambling.

Community Support

Although evidence shows a harm-reduction approach, as opposed to abstinence-only approach, is a more effective approach to both problem gambling and managing its long-term consequences, many gamblers find support groups such as Gambler’s Anonymous – like Alcoholics Anonymous – offer a community of like-minded people who can offer wisdom, compassion, share experiences, and help them manage their impulses and prevent relapse.

Finding Help: Resources

If you’re seeking treatment for your teen, please navigate to our page How to Find the Best Treatment Programs for Teens and download our helpful handbook, A Parent’s Guide to Mental Health Treatment for Teens.

In addition, the American Academy of Child and Adolescent Psychiatry (AACAP) is an excellent resource for locating licensed and qualified psychiatrists, therapists, and counselors in your area. Both the National Institute of Mental Health (NIMH) and the National Alliance on Mental Illness also provide and high-quality online resources, ready and waiting for you right now.