Journal of Gambling Studies

, Volume 26, Issue 2, pp 235–248 | Cite as

Age of Onset in Pathological Gambling: Clinical, Therapeutic and Personality Correlates

  • Susana Jiménez-Murcia
  • Eva M. Álvarez-Moya
  • Randy Stinchfield
  • Fernando Fernández-Aranda
  • Roser Granero
  • Neus Aymamí
  • Mónica Gómez-Peña
  • Nuria Jaurrieta
  • Francesca Bove
  • José M. Menchón
Original Paper


We aimed to explore the association between age of onset of gambling problems and current psychopathological and clinical status, personality profile and therapeutic outcome in a sample of pathological gamblers. A total of 904 consecutive pathological gambling patients were administered several instruments about gambling behavior, psychopathology and personality. They received a 4-month cognitive-behavioral group treatment. Information of dropouts and relapses during treatment was registered. Older age of onset of gambling problems was associated with higher general psychopathology (SCL-90-R Paranoid Ideation, Psychoticism, Depression; P < 0.015). Younger age of onset was related to greater severity of pathological gambling (P < 0.015), higher novelty seeking, and lower self-directedness (P < 0.015). No statistically significant association was found between age of onset and relapse and dropouts during treatment. Age of onset of gambling problems seems to influence the clinical presentation of pathological gambling but not treatment outcome.


Pathological gambling Age of onset Personality Psychopathology Cognitive-behavioral therapy 



This work is part of the PhD dissertation of Neus Aymami at the University Autonoma of Barcelona. Financial support was received from Fondo de Investigación Sanitaria -FIS (PI081573; PI081714) and AGAUR (2009SGR1554). It was also partially supported by the European Commission under the Seventh Framework Programme (FP7-ICT-215839-2007- Playmancer project). CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn) and CIBER Salud Mental (CIBERsam), are initiatives of ISCIII.


  1. Alessi, S. M., & Petry, N. M. (2003). Pathological gambling severity is associated with impulsivity in a delay discounting procedure. Behavioural Processes, 64(3), 345–354.CrossRefPubMedGoogle Scholar
  2. APA. (1987). Diagnostic and statistical manual of mental disorders (3rd ed. Revised). Washington, DC: American Psychiatric Association.Google Scholar
  3. APA. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: American Psychiatric Association.Google Scholar
  4. Argo, T. R., & Black, D. W. (2004). Clinical characteristics. In J. E. Grant & M. N. Potenza (Eds.), Pathological gambling: A clinical guide to treatment (pp. 39–53). Arlington: APPI.Google Scholar
  5. Babor, T. F., Dolinsky, Z. S., Meyer, R. E., Hesselbrock, M., Hofmann, M., & Tennen, H. (1992a). Types of alcoholics: Concurrent and predictive validity of some common classification schemes. British Journal of Addiction, 87, 1415–1431. doi: 10.1111/j.1360-0443.1992.tb01921.x.CrossRefPubMedGoogle Scholar
  6. Babor, T. F., Hofmann, M. I., DelBoca, F. K., Hesselbrock, V., Meyer, R. E., Dolinsky, Z. S., et al. (1992b). Types of alcoholics, I. Evidence for an empirically derived typology based on indicator of vulnerability and severity. Archives of General Psychiatry, 49, 599–608.PubMedGoogle Scholar
  7. Blaszczynski, A. (2005). Conceptual and methodological issues in treatment outcome research. Journal of Gambling Studies, 21(1), 5–11.CrossRefPubMedGoogle Scholar
  8. Blaszczynski, A., & Nower, L. (2002). A pathways model of problem and pathological gambling. Addiction, 97(5), 487–499.CrossRefPubMedGoogle Scholar
  9. Bondolfi, G., Osiek, C., & Ferrero, F. (2000). Prevalence estimates of pathological gambling in Switzerland. Acta Psychiatrica Scandinavica, 101(6), 473–475.CrossRefPubMedGoogle Scholar
  10. Breen, R. B., & Zimmerman, M. (2002). Rapid onset of pathological gambling in machine gamblers. Journal of Gambling Studies, 18(1), 31–43.CrossRefPubMedGoogle Scholar
  11. Burge, A. N., Pietrzak, R. H., Molina, C. A., & Petry, N. M. (2004). Age of gambling initiation and severity of gambling and health problems among older adult problem gamblers. Psychiatric Services, 55, 1437–1439.CrossRefPubMedGoogle Scholar
  12. Cloninger, C. R. (1999). The temperament and character inventory––revised. St Louis, MO: Center for Psychobiology of Personality, Washington University.Google Scholar
  13. Cloninger, C. R., Bohman, M., & Sigvardsson, S. (1981). Inheritance of alcohol abuse. Cross-fostering analysis of adopted men. Archives of General Psychiatry, 38, 861–868.PubMedGoogle Scholar
  14. Cloninger, C. R., Przybeck, T. R., Svrakic, D. M., & Wetzel, R. D. (1994). The temperament and character inventory (TCI): A guide to its development and use. St. Louis, Missouri: Center for Psychobiology of Personality.Google Scholar
  15. Cloninger, C. R., Svrakic, D. M., & Przybeck, T. R. (1993). A psychobiological model of temperament and character. Archives of General Psychiatry, 50(12), 975–990.PubMedGoogle Scholar
  16. Cunningham-Williams, R. M., & Hong, S. I. (2007). A latent class analysis (LCA) of problem gambling among a sample of community-recruited gamblers. Journal of Nervous and Mental Disease, 195(11), 939–947.CrossRefPubMedGoogle Scholar
  17. Derogatis, L. R. (1994). SCL-90-R. Cuestionario de 90 síntomas. [SCL-90-R. 90-Symptoms Questionnaire]. Madrid: TEA.Google Scholar
  18. Echeburúa, E., Báez, C., Fernández, J., & Páez, D. (1994). Cuestionario de juego patológico de South Oaks (SOGS): Validación española. [South Oaks Gambling Screen (SOGS): Spanish validation]. Anális Modific Cond, 20, 769–791.Google Scholar
  19. Fernández-Aranda, F., Jiménez-Murcia, S., Álvarez, E., Granero, R., Vallejo, J., & Bulik, C. M. (2006). Impulse control disorders in eating disorders: Clinical and therapeutic implications. Comprehensive Psychiatry, 47, 482–488.CrossRefPubMedGoogle Scholar
  20. González de Rivera, J. L. (2001). Version española del 90 Symptoms Check List Revised (SCL-90-R). [Spanish version of the 90-Symptoms Check List Revised (SCL-90-R)]. Madrid: TEA Ediciones.Google Scholar
  21. Gooding, P., & Tarrier, N. (2009). A systematic review and meta-analysis of cognitive-behavioural interventions to reduce problem gambling: Hedging our bets? Behaviour Research and Therapy, 47, 592–607.CrossRefPubMedGoogle Scholar
  22. Grant, J. E., Kim, S. W., Odlaug, B. L., Buchanan, S. N., & Potenza, M. N. (2009). Late-onset pathological gambling: Clinical correlates and gender differences. Journal of Psychiatric Research, 43(4), 380–387.CrossRefPubMedGoogle Scholar
  23. Gutiérrez, F., Torrens, M., Boget, T., Martín-Santos, R., Sangorrín, J., Pérez, G., et al. (2001). Psychometric properties of the temperament and character inventory (TCI) questionnaire in a Spanish psychiatric population. Acta Psychiatrica Scandinavica, 103, 143–147.CrossRefPubMedGoogle Scholar
  24. Gutiérrez-Zotes, J., Bayón, C., Montserrat, C., Valero, J., Labad, A., Cloninger, R., et al. (2004). Inventario del Temperamento y el Carácter-Revisado (TCI-R). Baremación y datos normativos en una muestra de población general. Actas Español Psiquiatría, 32(1), 8–15.Google Scholar
  25. Hodgins, D. C. (2005). Implications of a brief intervention trial for problem gambling for future outcome research. Journal of Gambling Studies, 21(1), 13–19.CrossRefPubMedGoogle Scholar
  26. Iancu, I., Lowengrub, K., Dembinsky, Y., Kotler, M., & Dannon, P. N. (2008). Pathological gambling: An update on neuropathophysiology and pharmacotherapy. CNS Drugs, 22(2), 123–138.CrossRefPubMedGoogle Scholar
  27. Jiménez-Murcia, S., Álvarez-Moya, E. M., Granero, R., Aymamí, M. N., Gómez-Peña, M., Jaurrieta, N., et al. (2005). Análisis de la eficacia de dos modalidades de tratamiento cognitivo-conductual grupal para el juego patológico [Analysis of the afficacy of two types of group cognitive-behavioral tratment for pathological gambling]. Psicología Conductual, 13(3), 497–512.Google Scholar
  28. Jiménez-Murcia, S., Álvarez-Moya, E. M., Granero, R., Aymamí, M. N., Gómez-Peña, M., Jaurrieta, N., et al. (2007). Cognitive-behavioral group treatment for pathological gambling: Analysis of effectiveness and predictors of therapy outcome. Psychotherapy Research, 17(5), 544–552.CrossRefGoogle Scholar
  29. Jiménez-Murcia, S., Aymamí-Sanromà, M. N., Gómez-Peña, M., Álvarez-Moya, E. M., & Vallejo, J. (2006). Protocols de tractament cognitivoconductual pel joc patològic i d’altres addiccions no tòxiques. [Guidelines of cognitive-behavioural treatment of pathological gambling and other non-toxic addictions]. Barcelona, Spain: Hospital Universitari de Bellvitge, Departament de Salut, Generalitat de Catalunya.Google Scholar
  30. Jimenez-Murcia, S., Stinchfield, R., Alvarez-Moya, E., Jaurrieta, N., Bueno, B., Granero, R., et al. (2009). Reliability, validity, and classification accuracy of a spanish translation of a measure of dsm-iv diagnostic criteria for pathological gambling. Journal of Gambling Studies, 25, 93–104.CrossRefPubMedGoogle Scholar
  31. Johansson, A., Grant, J. E., Kim, S. W., Odlaug, B. L., & Götestam, G. (2008). Risk factors for problematic gambling: A critical literature review. Journal of Gambling Studies. doi: 10.1007/s10899-008-9088-6.
  32. Kessler, R. C., Hwang, I., Labrie, R., Petukhova, M., Sampson, N. A., Winters, K. C., et al. (2008). DSM-IV pathological gambling in the national comorbidity survey replication. Psychological Medicine, 38(9), 1351–1360.CrossRefPubMedGoogle Scholar
  33. Kleinbaum, D. G., Kupper, L. L., Muller, K. E., & Nizam, A. (2007). Applied regression analysis and other multivariable methods (4th ed.). Houston: Cengage Learning.Google Scholar
  34. Ladouceur, R. (2005). Controlled gambling for pathological gamblers. Journal of Gambling Studies, 21(1), 49–57.CrossRefPubMedGoogle Scholar
  35. Ladouceur, R., Sylvain, C., Boutin, C., Lachance, S., Doucet, C., & Leblond, J. (2003). Group therapy for pathological gamblers: A cognitive approach. Behaviour Research and Therapy, 41(5), 587–596.CrossRefPubMedGoogle Scholar
  36. Ledgerwood, D. M., & Petry, N. M. (2006). Psychological experience of gambling and subtypes of pathological gamblers. Psychiatry Research, 144(1), 17–27.CrossRefPubMedGoogle Scholar
  37. Leggio, L., Kenna, G. A., Fenton, M., Bonenfant, E., & Swift, R. M. (2009). Typologies of alcohol dependence. From Jellinek to genetics and beyond. Neuropsychology Review, 19, 115–129.CrossRefPubMedGoogle Scholar
  38. Lesieur, H. R., & Blume, S. B. (1987). The South Oaks gambling screen (SOGS): A new instrument for the identification of pathological gamblers. American Journal of Psychiatry, 144(9), 1184–1188.PubMedGoogle Scholar
  39. Lesieur, H. R., & Rugle, L. (2000). Types of pathological gamblers. 14th national conference on problem gambling, Philadelphia, PA.Google Scholar
  40. Livingston, J. (1974). Compulsive gamblers: Observations on action and abstinence. New York: Harper Torchbooks.Google Scholar
  41. Lynch, W. J., Maciejewski, P. K., & Potenza, M. N. (2004). Psychiatric correlates of gambling in adolescents and young adults grouped by age at gambling onset. Archives of General Psychiatry, 61(11), 1116–1122.CrossRefPubMedGoogle Scholar
  42. Meyer, G. (1991). Classification of gamblers from self-help groups using cluster analysis. Zeitschrift fur Klinische Psychologie, Psychopathologie und Psychotherapie, 39(3), 261–282.PubMedGoogle Scholar
  43. Milton, S., Crino, R., Hunt, C., & Prosser, E. (2002). The effect of compliance-improving interventions on the cognitive-behavioural treatment of pathological gambling. Journal of Gambling Studies, 18(2), 207–229.CrossRefPubMedGoogle Scholar
  44. Nathan, P. E. (2005). Methodological problems in research on treatments for pathological gambling. Journal of Gambling Studies, 21(1), 109–114.CrossRefPubMedGoogle Scholar
  45. Oakley-Browne, M. A., Adams, P., & Mobberley, P. M. (2000). Interventions for pathological gambling. Cochrane Database of Systematic Reviews, (2), CD001521.Google Scholar
  46. Pallesen, S., Mitsem, M., Kvale, G., Johnsen, B.-H., & Molde, H. (2005). Outcome of psychosocial treatments of pathological gambling: A review and meta-analysis. Addiction, 100, 1412–1422.CrossRefPubMedGoogle Scholar
  47. Petry, N. M., Stinson, F. S., & Grant, B. F. (2005). Comorbidity of DSM-IV pathological gambling and other psychiatric disorders: Results from the national epidemiologic survey on alcohol and related conditions. Journal of Clinical Psychiatry, 66(5), 564–574.CrossRefPubMedGoogle Scholar
  48. Sartor, C. E., Scherrer, J. F., Shah, K. R., Xian, H., Volberg, R., & Eisen, S. A. (2007). Course of pathological gambling symptoms and reliability of the lifetime gambling history measure. Psychiatry Research, 152(1), 55–61.CrossRefPubMedGoogle Scholar
  49. Shaffer, H. J., Hall, M. N., & Van der Bilt, J. (1999). Estimating the prevalence of disordered gambling behavior in the United States and Canada: A research synthesis. American Journal of Public Health, 89, 1369–1376.CrossRefPubMedGoogle Scholar
  50. Shin, Y. C., Lim, S. W., Choi, S. W., Kim, S. W., & Grant, J. E. (2009). Comparison of temperament and character between early-and late-onset korean male pathological gamblers. Journal of Gambling Studies, doi:10.1007/s10899-0099-9125-0.
  51. Stinchfield, R. (2002). Reliability, validity, and classification accuracy of the South Oaks gambling screen (SOGS). Addictive Behaviors, 27(1), 1–19.CrossRefPubMedGoogle Scholar
  52. Stinchfield, R. (2003). Reliability, validity, and classification accuracy of a measure of DSM-IV diagnostic criteria for pathological gambling. American Journal of Psychiatry, 160(1), 180–182.CrossRefPubMedGoogle Scholar
  53. Stinchfield, R., & Winters, K. C. (2001). Outcome of Minnesota’s gambling treatment programs. Journal of Gambling Studies, 17(3), 217–245.CrossRefPubMedGoogle Scholar
  54. Strong, D. R., Daughters, S. B., Lejuez, C. W., & Breen, R. B. (2004). Using the Rasch model to develop a revised gambling attitudes and beliefs scale (GABS) for use with male college student gamblers. Substance Use and Misuse, 39(6), 1013–1024.CrossRefPubMedGoogle Scholar
  55. Tavares, H., Zilberman, M. L., Beites, F. J., & Gentil, V. (2001). Gender differences in gambling progression. Journal of Gambling Studies, 17(2), 151–159.CrossRefPubMedGoogle Scholar
  56. Toneatto, T., & Millar, G. (2004). The assessment and treatment of problem gambling: Empirical status and promising trends. Canadian Journal of Psychiatry, 49(8), 501–503.Google Scholar
  57. Turchi, R. M., & Derevensky, J. L. (2009). Youth gambling: Not a safe bet. Current Opinion in Pediatrics, 18, 454–458.CrossRefGoogle Scholar
  58. Vitaro, F., Arseneault, L., & Tremblay, R. E. (1997). Dispositional predictors of problem gambling in male adolescents. American Journal of Psychiatry, 154, 1769–1770.PubMedGoogle Scholar
  59. Wood, R. T., & Griffiths, M. D. (1998). The acquisition, development and maintenance of lottery and scratchcard gambling in adolescence. Journal of Adolescence, 21(3), 265–273.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Susana Jiménez-Murcia
    • 1
    • 2
  • Eva M. Álvarez-Moya
    • 2
  • Randy Stinchfield
    • 3
  • Fernando Fernández-Aranda
    • 1
    • 2
  • Roser Granero
    • 4
  • Neus Aymamí
    • 1
  • Mónica Gómez-Peña
    • 1
  • Nuria Jaurrieta
    • 1
  • Francesca Bove
    • 1
  • José M. Menchón
    • 1
    • 5
  1. 1.Department of Psychiatry, Pathological Gambling UnitBellvitge University HospitalBarcelonaSpain
  2. 2.CIBER Fisiopatologia Obesidad y Nutricion (CIBEROBN), Instituto Salud Carlos IIIBarcelonaSpain
  3. 3.Department of PsychiatryUniversity of Minnesota Medical SchoolMinneapolisUSA
  4. 4.Laboratori d’Estadística Aplicada, Departament de Psicobiologia i MetodologiaUniversitat Autònoma de BarcelonaBarcelonaSpain
  5. 5.CIBER Salud Mental (CIBERSAM), Instituto Salud Carlos IIIBarcelonaSpain

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