Children at Risk of Developing Problem Gambling

Transcription

1 The Problem Gambling Research and Treatment Centre A joint initiative of the Victorian Government, the University of Melbourne and Monash University Children at Risk of Developing Problem Gambling Nicki A Dowling Alun C Jackson Shane A Thomas Erica Frydenberg FINAL REPORT A Report to Gambling Research Australia in fulfilment of Tender 103/06 May 2010

2 i Acknowledgements The Children at Risk Project was funded by Gambling Research Australia (tender number 103/06). The researchers would like to acknowledge the assistance and support of McKinnon Secondary College, Gladstone Park Secondary College, Lalor Secondary College, Ruyton Girls School, Distance Education of Victoria, Ivanhoe Girls Grammar School, Debney Park Secondary School, University High School, Koonung Secondary College, Bellarine Secondary College, Mill Park Secondary College, Ashwood Secondary College, Lakeside Secondary College, Caulfield Park Community College, Wodonga Senior Secondary College, Lalor North Secondary College, and Trinity Grammar School in recruitment of participants for Study 2. We would like to express our sincere thanks to the Centre for Adult Education, Chisholm Institute of TAFE, Holmesglen TAFE, Monash University, the University of Melbourne, and Student Youth Network (SYN radio) for their support in recruiting participants for Study 3. We also extend our gratitude to our colleagues at Gambler s Help City (Vic), Gambler s Help Southern (Vic), Gambler s Help Grampians (Vic), Gambler s Help Eastern (Vic), the Statewide Gambling Therapy Service (SA), Break Even Problem Gambling Service (Tas), Gambler s Help South West (Vic), and Gambler s Help East Hume (Vic) for their assistance in recruiting participants for Study 4. We would like to acknowledge the assistance of the research assistants and fellows of the Problem Gambling Research and Treatment Centre for their support of this work: Julia Geraghty, Ramsay Dixon, Kate Francis, Sophia Vasiliadis, and Azusa Umemento. Finally, we extend our appreciation to the thousands of participants who contributed their valuable time.

3 ii About the Research Team Nicki Dowling, Senior Research Fellow, Problem Gambling Research and Treatment Centre, University of Melbourne. Chief Investigator responsible for literature review (Chapters 2 and 3) preparation; data analytic strategy; data analysis, reporting, and interpretation; data collection for Studies 3 and 4; project design; and manuscript preparation and review. Alun Jackson, Professor and Director, Problem Gambling Research and Treatment centre, University of Melbourne. Chief Investigator responsible for overall project management; data collection for Studies 2 and 3; guidelines (Chapter 10) preparation; project design; and manuscript preparation. Shane Thomas, Professor and Director, Problem Gambling Research and Treatment Centre, Monash University. Chief Investigator responsible for data collection for Study 1; guidelines (Chapter 10) preparation; project design; and manuscript preparation. Erica Frydenberg, Associate Professor, Melbourne Graduate School of Education, University of Melbourne. Chief Investigator responsible for data collection for Study 2; project design; and manuscript preparation. Julia Geraghty, Research Assistant, Problem Gambling Research and Treatment Centre, University of Melbourne. Ramsay Dixon, Research Assistant, Problem Gambling Research and Treatment Centre, University of Melbourne. Kate Francis, Research Fellow, Problem Gambling Research and Treatment Centre, University of Melbourne. Sophia Vasiliadis, Research Assistant, Problem Gambling Research and Treatment Centre, University of Melbourne. Azusa Umemento, Research Fellow, Problem Gambling Research and Treatment Centre, University of Melbourne.

4 iii Table of Contents Acknowledgements...i About the research team...ii Table of Contents...iii Table of Tables...viii Table of Figures...xvi EXECUTIVE SUMMARY CHILDREN AT RISK OF DEVELOPING PROBLEM GAMBLING...1 CHAPTER 1 BACKGROUND Key Outcomes Project Considerations Project Tasks...14 CHAPTER 2 RISK AND PROTECTIVE FACTORS FOR THE FAMILIAL TRANSMISSION OF PROBLEM GAMBLING BEHAVIOUR: LITERATURE REVIEW Introduction Intergenerational Transmission of Alcohol Use Problems The role of genetic factors in the intergenerational transmission of alcohol use problems The role of social learning in the intergenerational transmission of alcohol use problems A research framework for the study of the intergenerational transmission of alcohol use problems Magnitude of risk for the intergenerational transmission of alcohol use problems Specificity of risk for the intergenerational transmission of alcohol use problems Risk factors for the intergenerational transmission of alcohol use problems Protective factors for the intergenerational transmission of alcohol use problems Models of intergenerational transmission of alcohol use problems Concluding comments Intergenerational Transmission of Problem Gambling Behaviour The role of genetic factors in the intergenerational transmission of problem gambling behaviour The role of social learning in the intergenerational transmission of problem gambling behaviour A research framework for the study of the intergenerational transmission of problem gambling behaviour Magnitude of risk for the intergenerational transmission of problem gambling behaviour Specificity of risk for the intergenerational transmission of problem gambling behaviour...37

5 iv Risk factors for the intergenerational transmission of problem gambling behaviour Protective factors for the intergenerational transmission of problem gambling behaviour Sibling Transmission of Alcohol Use Problems Magnitude of risk for the sibling transmission of alcohol use problems Specificity of risk for the sibling transmission of alcohol use problems Risk factors for the sibling transmission of alcohol use problems Sibling Transmission of Problem Gambling Behaviour What Are The Gaps in our Understanding of The Familial Transmission of Problem Gambling Behaviour?...50 CHAPTER 3 METHODOLOGICAL CONSIDERATIONS: DEVELOPING A RESEARCH METHODOLOGY FOR THE CHILDREN AT RISK PROJECT Introduction Sample Selection Data Collection Strategies Family History Assessment Methods Study Design: Longitudinal and Cross-sectional Designs Consideration of the Potential Sources of Heterogeneity Cohabitation issues and relationship to the child Density of family history Lifespan developmental factors Gender of the problem gambling parent Other third variable influences Predominant gambling form Child characteristics Family structure Statistical Analyses Concluding Comments...59 CHAPTER 4 CHILDREN AT RISK PROJECT AIMS AND HYPOTHESES Introduction Project Aims Project Hypotheses...61 CHAPTER 5 STUDY 1: COMMUNITY TELEPHONE SURVEY Method Participants Measures Procedure Data analyses Results Gambling and problem gambling behaviour Familial transmission of problem gambling behaviour Paternal transmission of problem gambling behaviour...77

6 v Maternal transmission of problem gambling behaviour Sibling transmission of problem gambling behaviour Summary of Findings...90 CHAPTER 6 STUDY 2: SECONDARY SCHOOL SURVEY Method Participants Measures Procedure Data analyses Results Youth gambling and problem gambling behaviour Familial transmission of problem gambling behaviour Paternal transmission of problem gambling behaviour Maternal transmission of problem gambling behaviour Sibling transmission of problem gambling behaviour Summary of Findings CHAPTER 7 STUDY 3: YOUNG ADULT SURVEY Method Participants Measures Procedure Data analyses Results Young adult gambling and problem gambling behaviour Familial transmission of problem gambling behaviour Paternal transmission of problem gambling behaviour Maternal transmission of problem gambling behaviour Sibling transmission of problem gambling behaviour Summary of Findings CHAPTER 8 STUDY 4: SURVEY OF TREATMENT SEEKING PROBLEM GAMBLERS Method Participants Measures Procedure Data analyses Results Retrospective methodology Prospective methodology Summary of Findings CHAPTER 9 DISCUSSION Magnitude of Risk for the Familial Transmission of Problem Gambling Behaviour Specificity of Risk for the Familial Transmission of Problem Gambling Behaviour...175

7 vi 9.3 Risk Factors for the Familial Transmission of Problem Gambling Behaviour Expectancies and motives Psychopathology of the non-problem gambling parent Financial debts Substance use Depression Non-productive coping Gambling as a social norm Protective Factors for the Familial Transmission of Problem Gambling Behaviour Demographic characteristics Gambling expectancies Social capital Family characteristics Coping Consideration of the Potential Sources of Heterogeneity Cohabitation issues and relationship to the child Lifespan developmental factors Predominant gambling problem Methodological Limitations and Future Research Directions Concluding Comments CHAPTER 10 GUIDELINES FOR THE DEVELOPMENT OF INTERVENTION STRATEGIES/PROGRAMS FOR CHILDREN AT RISK OF DEVELOPING PROBLEM GAMBLING Primary Prevention Programs Community-based prevention School-based prevention Secondary Prevention Programs Community service settings School settings Tertiary Prevention Programs Interventions for individuals raised in problem gambling families Family-oriented interventions for problem gambling Treatment programs and services for adolescent problem gambling Protocols requiring coordinated service response for children living in problem gambling families Concluding Comments REFERENCES APPENDIX A Study 1: Data Preparation and assumption testing APPENDIX B Study 1: Regression tables APPENDIX C Study 2: List of participating schools...252

8 vii APPENDIX D Study 2: Data Preparation and assumption testing APPENDIX E Study 2: Regression tables APPENDIX F Study 3: List of sites APPENDIX G Study 3: Data Preparation and assumption testing APPENDIX H Study 3: Regression tables APPENDIX I Study 4: List of sites APPENDIX J Study 4: Data Preparation and assumption testing...304

9 viii Table of Tables Table 1 Control variables, risk factors, and protective factors assessed in the four Children at Risk Project studies...6 Table 2 A summary of the factors associated with problem gambling families and child problem gambling in the Children at Risk Project...9 Table 3 A summary of the risk and protective factors identified in the Children at Risk Project...10 Table 2.1 Examples of problems experienced by children of problem gamblers...16 Table 2.2 Possible risk factors for the intergenerational transmission of alcohol use problems...26 Table 2.3 Possible protective factors for the intergenerational transmission of alcohol use problems...27 Table 4.1 Control variables, risk factors, and protective factors assessed in the four Children at Risk Project studies...62 Table 5.1 Demographic characteristics of Study 1 participants...63 Table 5.2 Summary of variables examined in Study Table 5.3 Summary of the sample outcome...68 Table 5.4 Cross-tabulation of family member problem gambling and participant problem gambling risk categories...71 Table 5.5 Pearson s correlations between family member problem gambling, participant problem gambling, and control variables...72 Table 5.6 Pearson s correlations between family member problem gambling, participant problem gambling, and possible risk factors...74 Table 5.7 Cross-tabulation of paternal problem gambling and participant problem gambling risk categories...77 Table 5.8 Pearson s correlations between paternal problem gambling, participant problem gambling, and control variables...78 Table 5.9 Pearson s correlations between paternal problem gambling, participant problem gambling, and possible risk factors...80 Table 5.10 Cross-tabulation of maternal problem gambling and participant problem gambling risk categories...83

10 Table 5.11 Pearson s correlations between maternal problem gambling, participant problem gambling, and control variables...84 Table 5.12 Pearson s correlations between maternal problem gambling, participant problem gambling, and possible risk factors...86 Table 5.13 Cross-tabulation of sibling problem gambling and participant problem gambling risk categories...88 Table 5.14 Pearson s correlations between sibling problem gambling, participant problem gambling, and control variables...89 Table 5.15 Summary of the risk and protective factors identified in Study Table 6.1 Demographic characteristics of Study 2 participants...93 Table 6.2 Summary of variables examined in Study Table 6.3 Current (12-month) gambling activity participation for Study 2 participants Table 6.4 Cross-tabulation of gambling activities and people with whom participants gamble Table 6.5 Cross-tabulation of family member problem gambling and youth problem gambling risk categories Table 6.6 Pearson s correlations between family member problem gambling, youth problem gambling, and control variables Table 6.7 Pearson s correlations between family member problem gambling, youth problem gambling, and possible risk factors Table 6.8 Cross-tabulation of paternal problem gambling and youth problem gambling risk categories Table 6.9 Pearson s correlations between paternal problem gambling, youth problem gambling, and control variables Table 6.10 Pearson s correlations between paternal problem gambling, youth problem gambling, and possible risk factors Table 6.11 Cross-tabulation of maternal problem gambling and youth problem gambling risk categories Table 6.12 Pearson s correlations between maternal problem gambling, youth problem gambling, and control variables Table 6.13 Cross-tabulation of sibling problem gambling and youth problem gambling risk categories ix

11 Table 6.14 Pearson s correlations between sibling problem gambling, youth problem gambling, and control variables Table 6.15 Pearson s correlations between sibling problem gambling, youth problem gambling, and possible risk factors Table 6.16 Summary of the risk and protective factors identified in Study Table 7.1 Demographic characteristics of Study 3 participants Table 7.2 Summary of variables examined in Study Table 7.3 Current (12-month) gambling activity participation for Study 3 participants Table 7.4 Cross-tabulation of family member problem gambling and young adult problem gambling risk categories Table 7.5 Pearson s bivariate correlations between family member problem gambling, young adult problem gambling, and control variables Table 7.6 Pearson s correlations between family member problem gambling, young adult problem gambling, and possible risk factors Table 7.7 Cross-tabulation of paternal problem gambling and young adult problem gambling risk categories Table 7.8 Pearson s correlations between paternal problem gambling, young adult problem gambling, and control variables Table 7.9 Cross-tabulation of maternal problem gambling and young adult problem gambling risk categories Table 7.10 Pearson s correlations between maternal problem gambling, young adult problem gambling, and control variables Table 7.11 Pearson s correlations between maternal problem gambling, young adult problem gambling, and possible risk factors Table 7.12 Cross-tabulation of sibling problem gambling and young adult problem gambling risk categories Table 7.13 Pearson s correlations between sibling problem gambling, young adult problem gambling, and control variables Table 7.14 Summary of the risk and protective factors identified in Study Table 8.1 Demographic characteristics of Study 4 participants Table 8.2 Summary of variables examined in Study 4 (Retrospective) x

12 Table 8.3 Comparison of participants with family member problem gambling on possible risk and protective factors Table 9.1 A summary of the factors associated with problem gambling families and child/adult child problem gambling in the Children at Risk Project Table 9.2 A summary of the risk and protective factors identified in the Children at Risk Project Table 10.1 Research questions for the prevention of alcohol use problems for COAs that are applicable to children living in problem gambling families Table A.1 Psychometric properties of the major study variables for Study Table B.1 Prediction of participant gambling problems by family member gambling problems after controlling for other factors Table B.2 Age of first gamble as a possible risk factor for the familial transmission of problem gambling behaviour Table B.3 Paternal problem drinking as a possible risk factor for the familial transmission of problem gambling behaviour Table B.4 Maternal problem drinking as a possible risk factor for the familial transmission of problem gambling behaviour Table B.5 Maternal drug problems as a possible risk factor for the familial transmission of problem gambling behaviour Table B.6 Paternal mental health issues as a possible risk factor for the familial transmission of problem gambling behaviour Table B.7 Demographic factors as possible protective factors for the familial transmission of problem gambling behaviour Table B.8 Family characteristics as possible protective factors for the familial transmission of problem gambling behaviour Table B.9 Social capital as a possible protective factor for the familial transmission of problem gambling behaviour Table B.10 Prediction of participant gambling problems by paternal gambling problems after controlling for other factors Table B.11 Age of first gamble as a possible risk factor for the paternal transmission of problem gambling behaviour Table B.12 Maternal problem drinking as a possible risk factor for the paternal transmission of problem gambling behaviour xi

13 Table B.13 Maternal drug problems as a possible risk factor for the paternal transmission of problem gambling behaviour Table B.14 Paternal mental health issues as a possible risk factor for the paternal transmission of problem gambling behaviour Table B.15 Demographic factors as possible protective factors for the paternal transmission of problem gambling behaviour Table B.16 Family characteristics as possible protective factors for the paternal transmission of problem gambling behaviour Table B.17 Social capital as a possible protective factor for the paternal transmission of problem gambling behaviour Table B.18 Prediction of participant gambling problems by maternal gambling problems after controlling for other factors Table B.19 Paternal problem drinking as a possible risk factor for the maternal transmission of problem gambling behaviour Table B.20 Paternal mental health issues as a possible risk factor for the maternal transmission of problem gambling behaviour Table B.21 Demographic factors as possible protective factors for the maternal transmission of problem gambling behaviour Table B.22 Family characteristics as possible protective factors for the maternal transmission of problem gambling behaviour Table B.23 Social capital as a possible protective factor for the maternal transmission of problem gambling behaviour Table C.1 List of participating schools for Study Table D.1 Psychometric properties of the major study variables for Study Table E.1 Prediction of youth gambling problems by family member gambling problems after controlling for other factors Table E.2 Gambling attitudes as a possible risk factor for the familial transmission of problem gambling behaviour Table E.3 Parental separation/divorce as a possible risk factor for the familial transmission of problem gambling behaviour Table E.4 Financial debts as a possible risk factor for the familial transmission of problem gambling behaviour xii

14 Table E.5 Family dissatisfaction as a possible risk factor for the familial transmission of problem gambling behaviour Table E.6 Living situation dissatisfaction as a possible risk factor for the familial transmission of problem gambling behaviour Table E.7 Marijuana use as a possible risk factor for the familial transmission of problem gambling behaviour Table E.8 Other drug use as a possible risk factor for the familial transmission of problem gambling behaviour Table E.9 Demographic factors as possible protective factors for the familial transmission of problem gambling behaviour Table E.10 Parental employment as a possible protective factor for the familial transmission of problem gambling behaviour Table E.11 Coping as possible protective factors for the familial transmission of problem gambling behaviour Table E.12 Coping resources as a possible protective factor for the familial transmission of problem gambling behaviour Table E.13 Parenting practices as possible protective factors for the familial transmission of problem gambling behaviour Table E.14 Physical health as a possible protective factor for the familial transmission of problem gambling behaviour Table E.15 Prediction of youth gambling problems by paternal gambling problems after controlling for other factors Table E.16 Non-productive coping as a possible risk factor for the paternal transmission of problem gambling behaviour Table E.17 Parental separation/divorce as a possible risk factor for the paternal transmission of problem gambling behaviour Table E.18 Financial debts as a possible risk factor for the paternal transmission of problem gambling behaviour Table E.19 Family dissatisfaction as a possible risk factor for the paternal transmission of problem gambling behaviour Table E.20 Marijuana use as a possible risk factor for the paternal transmission of problem gambling behaviour Table E.21 Demographic factors as possible protective factors for the paternal transmission of problem gambling behaviour xiii

15 Table E.22 Parental employment as a possible protective factor for the paternal transmission of problem gambling behaviour Table E.23 Coping as a possible protective factor for the paternal transmission of problem gambling behaviour Table E.24 Coping resources as a possible protective factor for the paternal transmission of problem gambling behaviour Table E.25 Parenting practices as possible protective factors for the paternal transmission of problem gambling behaviour Table E.26 Physical health as a possible protective factor for the paternal transmission of problem gambling behaviour Table E.27 Prediction of youth gambling problems by sibling gambling problems after controlling for other factors Table E.28 Family dissatisfaction as a potential risk factor for the sibling transmission of problem gambling behaviour Table E.29 Living situation dissatisfaction as a potential risk factor for the sibling transmission of problem gambling behaviour Table E.30 Other drug as a possible risk factor for the sibling transmission of problem gambling behaviour Table E.31 Demographic factors as possible protective factors for the sibling transmission of problem gambling behaviour Table E.32 Parental employment as a possible protective factor for the sibling transmission of problem gambling behaviour Table E.33 Coping as a possible protective factor for the sibling transmission of problem gambling behaviour Table E.34 Coping resources as a possible protective factor for the sibling transmission of problem gambling behaviour Table E.35 Parenting practices as possible protective factors for the sibling transmission of problem gambling behaviour Table E.36 Physical health as a possible protective factor for the sibling transmission of problem gambling behaviour Table F.1 List of participating sites for Study Table G.1 Psychometric properties of the major study variables for Study xiv

16 Table H.1 Prediction of young adult gambling problems by family member gambling problems after controlling for other factors Table H.2 Self- enhancement expectancies as a possible risk factor for the familial transmission of problem gambling behaviour Table H.3 Money expectancies as a possible risk factor for the familial transmission of problem gambling behaviour Table H.4 Enhancement motives as a possible risk factor for the familial transmission of problem gambling behaviour Table H.5 Coping motives as a possible risk factor for the familial transmission of problem gambling behaviour Table H.6 Social motives as a possible risk factor for the familial transmission of problem gambling behaviour Table H.7 Depression as a possible risk factor for the familial transmission of problem gambling behaviour Table H.8 Alcohol use as a possible risk factor for the familial transmission of problem gambling behaviour Table H.9 Demographic factors as possible protective factors for the familial transmission of problem gambling behaviour Table H.10 Negative gambling expectancies as a possible protective factor for the familial transmission of problem gambling behaviour Table H.11 Prediction of young adult gambling problems by maternal gambling problems after controlling for other factors Table H.12 Enhancement motives as a possible risk factor for the maternal transmission of problem gambling behaviour Table H.13 Depression as a possible risk factor for the maternal transmission of problem gambling behaviour Table H.14 Demographic factors as possible protective factors for the maternal transmission of problem gambling behaviour Table H.15 Negative gambling expectancies as possible protective factors for the maternal transmission of problem gambling behaviour Table I.1 List of sites for study Table J.1 Psychometric properties of the major study variables for Study xv

17 xvi Table of Figures Figure 2.1 Illustration of the necessary conditions for demonstrating mediation...19 Figure 2.2 A model of moderation...20 Figure 2.3 Windle s model of the developmental psychopathology in COAs...28 Figure 2.4 Model of influence of parental alcohol use problems on offspring adjustment...29 Figure 2.5 The enhanced reinforcement etiologic pathway...31 Figure 2.6 The deviance proneness etiologic pathway...31 Figure 2.7 The negative affect etiologic pathway...32

18 1 EXECUTIVE SUMMARY CHILDREN AT RISK OF DEVELOPING PROBLEM GAMBLING Gambling Research Australia commissioned the Problem Gambling Research and Treatment Centre (PGRTC) to conduct the Children at Risk of Developing Problem Gambling (tender number 103/06) project (herein referred to as the Children at Risk Project). The focus of this research was on the risk factors for the development of gambling problems in children who have a family member with a gambling problem. The project tasks were to: Project goals 1. review the published literature on risk exposures and protective factors in relation to children in families where there is a problem gambler ; 2. develop an appropriate methodology to conduct an analysis of the risk exposures and their contribution towards the development of problem gambling in children, and 3. using the outcomes from the risk factor analysis, develop guidelines that policy makers and program developers can use in future population level interventions and strategies targeted at children at risk of developing problem gambling. Literature review aims and methods Project literature review The aim of the literature review was to explore the familial (parent and sibling) transmission of problem gambling and to identify the risk exposures and protective factors related to growing up in a problem gambling family. However, the transfer of gambling problems from parents or siblings has generally been neglected in the theoretical and empirical literature. We examined the suitability of several advanced research literatures to guide the selection of potentially relevant risk and protective factors and inform the design of appropriate methodologies in investigating the familial transmission of gambling problems. The alcohol use literature was among the most advanced and there are commonalities between the two disorders. We therefore: 1. examined the literature investigating the familial transfer of alcohol use problems in order to identify potentially relevant variables and theoretical models for understanding the development of problem gambling in children raised in problem gambling families; and 2. applied a research framework employed in the alcohol use literature to explore our current empirical and theoretical understanding of the development of gambling problems in children raised in problem gambling families. Research framework The research framework used in the Children at Risk Project comprised four research questions that addressed the project goals:

19 2 1. What is the magnitude of risk associated with family member problem gambling for the development of child problem gambling? 2. What is the specificity of risk associated with family member problem gambling for the development of child problem gambling? 3. What are the mediating mechanisms underlying the relationship between familial and child problem gambling? That is, what are the risk factors that explain why children raised in problem gambling families are more likely to develop problem gambling than children raised in non-problem gambling families? 4. What are the protective factors that may buffer the risk associated with family member problem gambling? Literature review findings We employed this research framework to structure the review and organise the extensive literature relating to the development of alcohol use problems in children raised in alcohol use problem families. We then applied the research framework to explore our current empirical and theoretical understanding of the transmission of gambling problems from parents (intergenerational transmission) and siblings (sibling transmission). The findings derived from the application of the research framework to the familial transmission of gambling problems is summarised below. Magnitude of risk for the intergenerational transmission of problem gambling behaviour The literature review showed that: There is now substantial evidence that there is a moderate risk associated with parental gambling problems, with research findings consistently indicating that children of problem gamblers are 2 to 4 times more likely to develop gambling problems themselves than the children of non-problem gamblers. Paternal problem gambling raises the risk for the development of child problem gambling more than maternal problem gambling. The magnitude of risk associated with parental problem gambling for the development of offspring gambling problems is substantial enough to warrant clinical and policy responses. Specificity of risk for the intergenerational transmission of problem gambling behaviour The literature review showed that: There is almost no literature that investigates whether the risk for problem gambling is specifically related to problem gambling or other issues associated with parental problem gambling. Further research is required to determine the degree to which the effects of parental problem gambling impact on offspring problem gambling above and beyond those of co-occurring parental psychiatric disorders such as affective disorders, anxiety disorders, alcohol and substance use problems, and personality disorders.

20 3 Risk factors for the intergenerational transmission of problem gambling behaviour The literature review showed that: There is general agreement that both genetic and environmental factors are influential in the intergenerational transmission of problem gambling behaviour. Empirical research suggests that genetics have a relatively weak but significant impact on the risk of developing problem gambling, particularly for males. There is also evidence that child and adolescent gambling is promoted by family members and friends acting as significant models for gambling. The variation in problem gambling outcomes for the children of problem gamblers implies that there are risk factors that mediate or explain problem gambling outcomes. There may be multiple interpretations of risk exposures in the context of the familial transmission of problem gambling. In the Children at Risk Project, we have defined a risk exposure as a mediating factor as this type of risk factor can potentially explain how or why the familial transmission of problem gambling behaviour occurs. Little is known about the risk mechanisms by which parental problem gambling may result in elevations in offspring problem gambling. In order to identify risk factors that explain how or why the relationship between family member and child problem gambling occurs, studies need to employ statistical analyses that simultaneously test all the requisite relationships between parental problem gambling, possible risk factors, and offspring problem gambling. The few studies that appropriately test all of these relationships suggest that offspring gambling cognitions and parenting practices may explain part of the relationship between parental and offspring problem gambling. Potentially relevant variables for study in explaining the intergenerational transmission of problem gambling may also be derived from: 1. Studies that have identified the environmental characteristics of problem gambling families. The findings from these studies suggest that risk factors for the intergenerational transmission of gambling problems may include family dysfunction, ineffective parenting practices and styles, dyadic relationship dysfunction, co-occurring parental psychopathology, impaired family coping, family violence, and gambling-related financial consequences. However, the failure of these studies to measure offspring problem gambling precludes the conclusion that such conditions are related to the development of offspring problem gambling. 2. Studies that have examined the correlates of youth problem gambling. The findings of these studies suggest that risk factors for the intergenerational transmission of gambling problems may include personality factors (e.g., sensation seeking and impulsivity), emotional distress, impaired coping, alcohol and substance use, risk-taking behaviours, gambling attitudes and beliefs, gambling expectancies, and family problems. However, the failure of these studies to measure parental problem gambling precludes the interpretation that these correlates explain the intergenerational transmission of problem gambling.