Persons with pathological gambling are more likely than controls to be divorced, live alone, and report evidence of disturbed family life. They are also likely to report childhood maltreatment, including physical, emotional, and sexual abuse, at rates greater than among controls. Our study adds to the literature by confirming these differences in a wellcharacterized sample of persons with pathological gambling and controls selected through random digit dialing methods. Importantly, among persons with pathological gambling, increasing gambling severity (measured with the SOGS and NODS) was positively correlated with worse family functioning in terms of FAD subscale scores, divorce, and childhood maltreatment.
As evidence of unstable marital life, pathological gamblers report having more divorces than controls, are more likely to be currently divorced, and are more likely to live alone. The results are consistent with clinical and epidemiologic studies that show higher rates of divorce in persons with pathological gambling than in comparison groups.23
These findings are not entirely surprising in light of the known effect of having a spouse with pathological gambling. Lorenz and Yaffee24
found that women belonging to Gam-Anon frequently endorsed feelings of anger or resentment toward their spouse (74%), depression (47%), isolation (44%), and guilt about contributing to his gambling (30%), while 86% contemplated leaving their gambling spouses and 29% did so. Sexual intimacy is another casualty of pathological gambling.25,26
Childhood maltreatment has been associated with several psychiatric disorders including borderline personality disorder and posttraumatic stress disorder.27–29
In the current study, we found that 61 % of subjects with pathological gambling reported experiencing some type of childhood maltreatment, including emotional, verbal, physical or sexual abuse, as well as neglect. These rates are comparable to those recently reported by Felsher et al.16
While the impact of childhood maltreatment is unclear, Jacobs30
suggests that negative feelings and rejection in childhood may lead a person to seek aversive stimuli to modulate their negative affective state. This theory is partially consistent with the pathways model proposed by Blaszczynski and Nower,31
which describes a subgroup of “emotionally vulnerable gamblers” who suffer premorbid depression or anxiety. They have a history of poor coping, frequent life events, and adverse developmental experiences including abuse. For these individuals, gambling serves to modulate negative affective states or to meet other psychological needs. Although we do not know the direction of the relationship between abuse and pathological gambling, the fact that persons with pathological gambling report high rates of childhood maltreatment is at the very least another indicator of family dysfunction.
Pathological gambling families had higher (more pathological) scores than control families on all FAD subscales; this was also true for 6 of 7 subscales when the families were rated as “healthy” or “unhealthY:” Thus, family dysfunction is not limited to 1 specific domain of functioning, but occurs in all rated dimensions indicating more generalized dysfunction, rather than targeted issues. Dysfunction ranges from poor communication to inability to resolve problems. While these observations will not surprise those who work with pathological gambling families, this study provides an objective assessment documenting the extent of the family problems.
These data extend what is known about the families of persons with disordered gambling.4
While it has been known for decades that pathological gambling has a negative impact on families, only recently have quantitative data confirmed these observations. Bergh and Kühlhorn32
found in a sample of 40 pathological gamblers that pathological gambling caused problems for at least 1 family member for 83% of their sample, mainly marital problems or having no time for children. In a quantitative study of nuclear families, Ciarrocchi and Reinert33
recruited 67 married male problem gamblers (34 with alcohol dependence, 33 Without) from treatment programs and had them complete the Family Environment Scale (FES),34
a self-report measure of family structure and relations. Compared with control families, the gamblers scored significantly lower on family commitment and support; they also scored lower on independence within their families. Those in the problem gambling–only group reported a lower level of familial participation in intellectual activities, and the gamblers who were also alcohol dependent reported a significantly higher level of expressed anger within the family. Both groups differed Significantly from controls on 6 of 10 FES subscales.
The findings raise questions about the strength and direction of these associations. Does pathological gambling contribute directly to poor marital and family functioning, or are persons with these problems more likely to become pathological gamblers? Gambling could contribute to these problems through its direct impact on the family budget, or to time devoted to gambling taken at the expense of family togetherness. The prevarication, untruthfulness, or illegal behaviors that often accompany pathological gambling also undermine the family unit. However, it is important to recognize that the families of gamblers are often filled with members who are psychiatrically ill or addicted to alcohol or drugs, and this would have an independent and negative impact on family life.35
There are several methodological limitations to acknowledge. First, people with pathological gambling were mainly recruited through a study registry, advertising, or participation in treatment programs and not through epidemiologic sampling methods. Therefore, the pathological gamblers may not be representative of persons with pathological gambling as a whole. Next, data were largely obtained through self-report, and it is possible that a subject’s perception of his or her marital and family functioning is inaccurate because of denial or exaggeration. For example, people sometimes underreport the extent of marital or family discord due to embarrassment. Lastly, the large number of outcomes tested could have resulted in a higher risk of a type I error.