Journal of Gambling Studies

, Volume 31, Issue 3, pp 1005–1013 | Cite as

Gambling-Related Problems as a Mediator Between Treatment and Mental Health with At-Risk College Student Gamblers

  • Irene Markman Geisner
  • Sarah Bowen
  • Ty W. Lostutter
  • Jessica M. Cronce
  • Hollie Granato
  • Mary E. Larimer
Original Paper


Disordered gambling has been linked to increased negative affect, and some promising treatments have been shown to be effective at reducing gambling behaviors and related problems (Larimer et al. in Addiction 107:1148–1158, 2012). The current study seeks to expand upon the findings of Larimer et al. (Addiction 107:1148–1158, 2012) by examining the relationship between gambling-related problems and mental health symptoms in college students. Specifically, the three-group design tested the effects of two brief interventions for gambling—an individual, in-person personalized feedback intervention (PFI) delivered using motivational interviewing and group-based cognitive behavioral therapy, versus assessment only on mood outcomes. The mediating effect of gambling-related problems on mood was also explored. Participants (N = 141; 65 % men; 60 % Caucasian, 28 % Asian) were at-risk college student gamblers [South Oaks Gambling Screen (Lesieur and Blume in Am J Psychiatry 144:1184–1188, 1987) ≥3], assessed at baseline and 6-month follow-up. Gambling problems were assessed using the Gambling Problems Index (Neighbors et al. in J Gamb Stud 18:339–360, 2002). Mental health symptoms were assessed using the depression, anxiety, and hostility subscales of the Brief Symptom Inventory (Derogatis in Brief Symptom Inventory (BSI): administration, scoring, and procedures manual, National Computer Systems, Inc., Minneapolis, 1993). Results revealed that the PFI condition differentially reduced negative mood, and that reductions in gambling-related problems partially mediated this effect. Implications for intervention for comorbid mood and gambling disorders are discussed.


College students Gambling Mental health Comorbidity 



The research was supported by the National Institute on Drug Abuse Grant # R01 DA025051, the National Institute of Mental Health R21 MH067026 and National Institute on Alcohol Abuse and Alcoholism T32 AA007455 all awarded to Mary E. Larimer.


  1. Anderson, B. (2007). Collaborative care and motivational interviewing: Improving depression outcomes through patient empowerment interventions. American Journal of Managed Care, 13, S103–S108.PubMedGoogle Scholar
  2. Barnes, G. M., Welte, J. W., Hoffman, J. H., & Tidwell, M.-C. O. (2010). Comparisons of gambling and alcohol use among college students and noncollege young people in the United States. Journal of American College Health, 58, 443–452. doi: 10.1080/07448480903540499.PubMedCentralCrossRefPubMedGoogle Scholar
  3. Beaudoin, C. M., & Cox, B. J. (1999). Characteristics of problem gambling in a Canadian context: A preliminary study using a DSM-IV–based questionnaire. Canadian Journal of Psychiatry, 44, 483–487.Google Scholar
  4. Bergevin, T., Gupta, R., Derevensky, J., & Kaufman, F. (2006). Adolescent gambling: Understanding the role of stress and coping. Journal of Gambling Studies, 22, 195–208.CrossRefPubMedGoogle Scholar
  5. Blaszczynski, A., & Nower, L. (2002). A pathways model of problem and pathological gambling. Addiction, 97, 487–499.CrossRefPubMedGoogle Scholar
  6. Blinn-Pike, L., Lokken Worthy, S., & Jonkman, J. N. (2007). Disordered gambling among college students: A meta-analytic synthesis. Journal of Gambling Studies, 23, 175–183.CrossRefPubMedGoogle Scholar
  7. Carver, C. (1997). You want to measure coping but your protocol’s too long: Consider the brief COPE. International Journal of Behavioral Medicine, 4, 92–100.CrossRefPubMedGoogle Scholar
  8. Derogatis, L. R. (1993). Brief Symptom Inventory (BSI): Administration, scoring, and procedures manual (3rd ed.). Minneapolis, MN: National Computer Systems Inc.Google Scholar
  9. Dimeff, L. A., Baer, J. S., Kivlahan, D. R., & Marlatt, G. A. (1999). Brief alcohol screening and intervention for college students. New York: Guilford Press.Google Scholar
  10. Diskin, K. M., & Hodgins, D. C. (2009). A randomized controlled trial of a single session motivational intervention for concerned gamblers. Behaviour Research and Therapy, 47(5), 382–388.Google Scholar
  11. Endler, N., & Parker, J. (1990). Multidimensional assessment of coping: A critical evaluation. Journal of Personality and Social Psychology, 58, 844–854.CrossRefPubMedGoogle Scholar
  12. Geisner, I. M., Neighbors, C., & Larimer, M. E. (2006). A randomized clinical trial of a brief, mailed intervention for symptoms of depression. Journal of Consulting and Clinical Psychology, 74, 393–399.CrossRefPubMedGoogle Scholar
  13. Gupta, R., & Derevensky, J. L. (1998). Adolescent gambling behavior: A prevalence study and examination of the correlates associated with problem gambling. Journal of Gambling Studies, 14(4), 319–345.Google Scholar
  14. Gupta, R., & Derevensky, J. L. (2000). Adolescents with gambling problems: From research to treatment. Journal of Gambling Studies, 16(2–3), 315–342.Google Scholar
  15. Hodgins, D., Peden, N., & Cassidy, E. (2005). The Association between comorbidity and outcome in pathological gambling: A prospective follow-up of recent quitters. Journal of Gambling Studies, 21, 255–271. doi: 10.1007/s10899-005-3099-3.CrossRefPubMedGoogle Scholar
  16. Larimer, M. E., Neighbors, C., Lostutter, T. W., Whiteside, U., Cronce, J. M., Kaysen, D., et al. (2012). Brief motivational feedback vs. cognitive behavioral intervention for prevention of disordered gambling: A randomized clinical trial. Addiction, 107, 1148–1158.PubMedCentralCrossRefPubMedGoogle Scholar
  17. 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, 1184–1188.CrossRefPubMedGoogle Scholar
  18. Lightsey, O. R., & Hulsey, C. D. (2002). Impulsivity, coping, stress, and problem gambling among university students. Journal of Counseling Psychology, 49, 202–211.CrossRefGoogle Scholar
  19. Lorains, F. K., Cowlishaw, S., & Thomas, S. A. (2011). Prevalence of comorbid disorders in problem and pathological gambling: systematic review and meta-analysis of population surveys. Addiction, 106(3), 490–498. doi: 10.1111/j.1360-0443.2010.03300.x.CrossRefPubMedGoogle Scholar
  20. Martin, R. J., Usdan, S., Cremeens, J., & Vail-Smith, K. (2013). Disordered gambling and co-morbidity of psychiatric disorders among college students: An examination of problem drinking, anxiety and depression. Journal of Gambling Studies,. doi: 10.1007/s10899-013-9367-8.Google Scholar
  21. Maxwell, S. E., Cole, D. A., & Mitchell, M. A. (2011). Bias in cross-sectional analyses of longitudinal mediation: Partial and complete mediation under an autoregressive model. Multivariate Behavioral Research, 46, 816–841.CrossRefGoogle Scholar
  22. Miller, W. R., & Rollnick, S. (2002). Motivational interviewing: Preparing people for change. Guilford press.Google Scholar
  23. Moore, S. M., Thomas, A. C., Kalé, S., Spence, M., Zlatevska, N., Staiger, P. K., et al. (2013). Problem gambling among International and Domestic University Students in Australia: Who is at risk? Journal of Gambling Studies, 29, 217–230.CrossRefPubMedGoogle Scholar
  24. Neighbors, C., Lostutter, T. W., Larimer, M. E., & Takushi, T. (2002). Measuring gambling outcomes among college students. Journal of Gambling Studies, 18, 339–360.PubMedCentralCrossRefPubMedGoogle Scholar
  25. Nowak, D. E., & Aloe, A. M. (2013). The prevalence of pathological gambling among college students: A meta-analytic synthesis, 2005–2013. Journal of Gambling Studies,. doi: 10.1007/s10899-013-9399-0.Google Scholar
  26. Nower, L., Derevensky, J. L., & Gupta, R. (2004). The relationship of impulsivity, sensation seeking, coping, and substance use in youth gamblers. Psychology of Addictive Behaviors, 18, 49–55.CrossRefPubMedGoogle Scholar
  27. 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, 564–574.CrossRefPubMedGoogle Scholar
  28. Petry, N. M., Weinstock, J., Ledgerwood, D. M., & Morasco, B. (2008). A randomized trial of brief interventions for problem and pathological gamblers. Journal of Consulting and Clinical Psychology, 76, 318–328.PubMedCentralCrossRefPubMedGoogle Scholar
  29. Petry, N. M., Weinstock, J., Morasco, B. J., & Ledgerwood, D. M. (2009). Brief motivational interventions for college student problem gamblers. Addiction, 104(9), 1569–1578.PubMedCentralCrossRefPubMedGoogle Scholar
  30. Planzer, S., Gray, H. M., & Shaffer, H. J. (2013). Associations between national gambling policies and disordered gambling prevalence rates within Europe. International Journal of Law and Psychiatry.
  31. Preacher, K. J., & Hayes, A. F. (2004). SPSS and SAS procedures for estimating indirect effects in simple mediation models. Behavior Research Methods, Instruments & Computers, 36(4), 717–731.Google Scholar
  32. Preacher, K. J., & Hayes, A. F. (2008). Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behavior Research Methods, 40, 879–891.CrossRefPubMedGoogle Scholar
  33. Preacher, K. J., Rucker, D. D., & Hayes, A. F. (2007). Addressing moderated mediation hypotheses: Theory, methods, and prescriptions. Multivariate Behavioral Research, 42(1), 185–227.Google Scholar
  34. Shaffer, H. J., & Hall, M. N. (2001). Updating and refining prevalence estimates of disordered gambling behavior in the United States and Canada. Canadian Journal of Public Health, 92(3), 168–172.Google Scholar
  35. Tabachnick, B. G., & Fidell, L. S. (2001). Using multivariate statistics (4th ed.). Boston: Allyn and Bacon.Google Scholar
  36. Weinstock, J., & Petry, N. M. (2008). Pathological gambling college students’ perceived social support. Journal of College Student Development, 49(6), 625–632.PubMedCentralCrossRefPubMedGoogle Scholar
  37. Westra, H. A., & Dozois, D. J. A. (2006). Preparing clients for cognitive behavioral therapy: A randomized pilot study of motivational interviewing for anxiety. Cognitive Therapy and Research, 30, 481–498.CrossRefGoogle Scholar
  38. Whiteside, U., Cronce, J. M., Pedersen, E. R., & Larimer, M. E. (2010). Brief motivational feedback for college students: A harm reduction approach. Journal of Clinical Psychology. In Session, 66, 150–163.PubMedGoogle Scholar
  39. Wohl, M. J. A., Matheson, K., Young, M. M., & Anisman, H. (2008). Cortisol rise following awakening among problem gamblers: Dissociation from comorbid symptoms of depression and impulsivity. Journal of Gambling Studies, 24, 79–90.CrossRefPubMedGoogle Scholar
  40. Wood, R. T. A., & Griffiths, M. D. (2007). A qualitative investigation of problem gambling as an escape-based coping strategy. Psychology and psychotherapy: Theory, research and practice, 80, 107–125.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Irene Markman Geisner
    • 1
  • Sarah Bowen
    • 1
  • Ty W. Lostutter
    • 1
  • Jessica M. Cronce
    • 1
  • Hollie Granato
    • 1
  • Mary E. Larimer
    • 1
  1. 1.Department of Psychiatry and Behavioral Sciences, Center for the Study of Health and Risk BehaviorsUniversity of WashingtonSeattleUSA

Personalised recommendations