Gambling transitions among adult gamblers: A multi-state model using a Markovian approach applied to the JEU cohort

Addict Behav. 2016 Jun;57:13-20. doi: 10.1016/j.addbeh.2016.01.010. Epub 2016 Jan 22.


Introduction: The aim of this paper is to study transitions between two states of gambling in adulthood (problem gambling and non-problem gambling) and to identify factors that might influence these transitions.

Methods: Data for this 2-year long longitudinal study were collected in a French Outpatient Addiction Treatment Center, in gambling establishments and through the press. Both problem gamblers and non-problem gamblers were evaluated using a structured interview and self-report questionnaires. The statistical analysis was carried out using a Markovian approach.

Results: The analyzed cohort consisted of 304 gamblers with 519 observed transitions. Participants with no past-year gambling problems (based on the DSM-IV) had a probability of about 90% of also having no past-year gambling problems at the following assessment, whereas the observed percentage of problem gamblers transitioning to non-problem gambling was of 48%. We reported (i) vulnerability factors of transitioning to problem gambling (such as an anxiety disorder or an Attention Deficit Hyperactivity Disorder (ADHD) during the childhood), (ii) protective factors for non-problem gamblers, (iii) recovery factors (such as ongoing treatment and younger age) and (iv) persistence factors of a gambling problem (such as a persistent ADHD).

Conclusions: The status of problem gambler is unstable over time, whereas we found stability among non-problem gamblers. Our findings suggest the existence of vulnerability and protective factors in gambling. These results lead to think about preventive actions and adaptive care, such as cognitive-behavioral therapy or researching gambling problems in people with an anxiety disorder or ADHD.

Keywords: Gambling; Longitudinal study; Markov process; Prevalence; Risk factors; Transitions.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Age of Onset
  • Aged
  • Anxiety Disorders / psychology
  • Attention Deficit Disorder with Hyperactivity / psychology
  • Attitude to Health
  • Epidemiologic Methods
  • Female
  • Gambling / psychology*
  • Gambling / rehabilitation
  • Humans
  • Male
  • Middle Aged
  • Socioeconomic Factors