Risikofaktoren und Verlauf des problematischen Glücksspielverhaltens an Geldspielautomaten. Ergebnisse einer Längsschnittstudie mit Automatenspielern.

In Germany a total number of 4.63 million active slot-machine gamblers are assumed. 54.000 persons out of them show a gambling-related subjective problem. The number of persons with a problematic gambling behaviour on slot-machines is estimated at 25.000 – 30.000. In comparison with other gambling options German-style slot machines seem to increase the risk for the development of a pathological gambling behaviour. Worldwide there exist 9 longitudinal studies dealing with problematic gambling behaviour. Data of longitudinal studies as well as those of cross-sectional studies give only little information on solid results concerning the risk factors and the course of a problematic respectively pathological gambling behaviour. For this reason this prospective longitudinal study dealt on the one hand with the course of problematic gambling behaviour, on the other hand with possible correlates and risk factors. “Problematic gambling behaviour” was thus chosen as an overall term as well as for pathological gambling behaviour as also for less heavy forms of an already dysfunctional gambling behaviour and defined respectively. Due to the postulated high risk potential of German-style slot machines the survey concentrated on slot machine gamblers. As the first time of investigation took place shortly after the reunion of Germany, only persons from the new Federal Laender were chosen as specially suited sample for studying the course of gambling behaviour as they had only little contact with slot machines before. These persons were contacted and asked by trained interviewers according to a combined random quota system. The investigations were made with active, regular slot machine gamblers. The interviews for this study, beginning in 1991, were made four times at intervals of one year. 513 slot machine gamblers took part in the first wave, of which 334 persons could also be interviewed in the fourth wave. The response rate of 65% is absolutely satisfactory in comparison to other longitudinal studies. During the first investigation period socio-demographic patterns, aspects of gambling behaviour, gambling-related cognition, gambling motivation, subjective gambling related impairment, criminal offences caused by gambling, need of treatment, psycho-social dissatisfaction, alcohol problems, drug use as well as depression as a possible correlate of problematic slot machine gambling were assessed. Problematic gambling behaviour was defined according to the criteria of a Rasch scale Spielerbelastungsfragebogen (SBF) [Problem Gambling Questionnaire] for the measurement of problem gambling. Moreover it was checked if these variables measured at T0 (wave 1) worked possibly as risk factors for the development of a problem gambling till T 3(wave 4). In addition the problem and non-problem gambling behaviour of the participants was examined with regard to constancy and variability between the T0 to T4. A multiple logistical regression analyses found out that gender, excessive gambling, gambling-related cognitive dysfunctions, subjective gambling-related impairment, alcohol problems and depression, investigated during T0, were significant correlates of slot machine problem gambling behaviour. The strongest association appeared for depression, which has a sevenfold increased probability to produce a problem gambling. Regarding the development of a gambling behaviour, an analysis of progression showed that from T0 to T3 the number of excessive gamblers decreased to a non-significant extent whereas the number of non-frequent gamblers decreased significantly and the number of occasional gamblers increased significantly. In detail two-third of the non-frequent gamblers became occasional gamblers, whereas one-third furthermore gambled non-frequently. In most cases occasional gamblers remained occasional gamblers. 72% of the excessive gamblers out of T0 were still excessive gamblers in T3, whereas the rest gambled only occasionally. Between T0 and T3 there was a significant increase of the rate of problematic gamblers from 14% to 35% whereas all problem gamblers from T0 remained in this category also in T3. Moreover, 25% of the non-problem gamblers out of wave 3 developed a problem gambling behaviour till T3. The risk factors for the development of a problem gambling behaviour till T3 were analysed with a multiple logistical regression. It became obvious that a negative reason for gambling as well as depression, found out in T0, increased the risk of a problem gambling behaviour in T3 by 2.5. Particularly interesting is the importance of depression both as correlative and as risk factor for problem gambling and negative playgrounds as risk factor. Moreover, special attention has to be concentrated on the 28% excessive gamblers developing during the course of four years of study positively into occasional gamblers. At least it is of central interest that on one hand a high number of gamblers developed a gambling problem after four years (25%) and that on the other hand the gambling problems of the problem gamblers out of T0 were extensively constant. These results have to be discussed against the background of some methodical problems. On one hand a selected group of gamblers was interviewed for the analysis of progression and the risk factor analysis as not all 513 participants of T0 could be contacted at T3. However, the contacted 334 persons were comparable with the other participants concerning socio-demographic attributes as well as criteria relevant to gambling so that no systematic failures have to be considered. On the other hand the rate of excessive gamblers was over-represented due to the intention of the study. For this reason it is not allowed to generalize the prevalences and incidences of this study to the group of gamblers. They serve – for the group under examination – only as a trend analysis in order to give evidence about the progression of excessive gambling respectively problem gambling behaviour. The results found in this study are based mainly on the statements of male gamblers which also allow no generalization for female gamblers. Due to the results of this study the models on the development of problem gambling, postulating the role of negative reasons and depression for the development of a problem gambling behaviour, have an empirical evidence. These results are also of great importance for treatment, as the procurement of coping-strategies for handling negative emotions on the basis of the available results seems to be important for at least one part of the problem gamblers. Further reflections and conclusions for research and practice are described.