Latino Problem Gambling

Consultant Cesar Angomas representing the Council at a festival.

By Thalia Yunen, Communications Intern, Massachusetts Council on Compulsive Gambling

For this week’s blog, I decided to write about an area that personally relates to me when discussing problem gambling. As a young Latina woman, I am interested in problem gambling within the Latino community. When I started this blog, I hoped to have a lengthy piece with plenty of statistics, filled with personal as well as non-personal observations on what it means to be a problem gambler within my community. However, as I started to conduct my research, I found that there wasn’t a wealth of information about problem gambling amongst Latinos.

Here’s a little about me. My mother is Dominican and her family is of Spanish descent, and my father is Puerto Rican and his family is of Lebanese descent. I often get asked where I’m from, and for the most part people think I’m either Middle Eastern or Hispanic. It always amuses me to hear all their guesses. Like me, Latinos, sometimes referred to as Hispanics, are diverse – from the Afro-Cuban to the White-Argentinian, not that these are two ends of the racial or ethnic spectrum, but they differ in terms of physical features and accent and even cultural beliefs. This is why looking at problem gambling from a Latino standpoint is interesting to me. With that said, I realize that with a culture so broad and rich, it’s especially difficult to educate people on, raise awareness about, and prevent problem gambling.

Like most Latinos who have a tío (uncle) or abuela (grandmother) who occasionally gamble, I was never fully informed or knew that places existed to help anyone that I knew if their activity progressed to having a gambling disorder. I knew gambling was an issue, but I usually saw it as a result of something else unraveling in a person’s life, like if they had a substance abuse or mental health disorder. I wasn’t entirely wrong. According to the Mass. Council’s fact sheet, Gambling and Disordered Gambling Facts, of the people diagnosed with a gambling disorder, about 75% had an alcohol disorder, 38% had a drug use disorder, and 60% were nicotine dependent. These statistics surprised me. Before interning at the Massachusetts Council on Compulsive Gambling, I never knew that gambling was a problem to be dealt with in itself, I only saw it as a gateway to other addictions – which it can be, but this is not always the case.

Common forms of gambling in the Latino community include:

• Lottery
• Animal Fights
• Bingo
• Raffles
• Dominoes
• Cultural Games
• Informal Gaming
• Sports Betting
• Casinos

Council Consultant, Cesar Angomas, says that the majority of Latinos, like many others experiencing problems with gambling, call the Council when they are at risk of losing something, like their family, a job, their marriage, or something else of value. Angomas also notes that Hispanics and Latinos usually are in denial because culturally, gambling is thought of as a hobby, not a disease, or a disorder. He said, “Since it’s always been legal, they see it mostly as entertainment or a hobby. And it slowly starts becoming a strong addiction; they start to become dependent on ‘the game’. Then they start thinking according to the game, wasting their time or their thoughts on their next gamble.” Angomas also says that most Latinos that he meets will come to him and say, “I don’t understand addiction; I don’t know what it means. Do you have any materials or resources to show me?”

In 2009, the Northstar Problem Gambling Alliance (NPGA) partnered with Comunidades Latinas Unidas En Servicio (CLUES), a provider of behavioral health and human services to Latinos in Minnesota, to hold a roundtable discussion with Latino individuals to discuss how gambling affected their lives, their families, and their community. (Read more about their findings here.)

Most of the recommendations provided suggest that more information and bilingual resources would be beneficial to the Latino community. Another prevalent attitude amongst the Latinos in the study was that gambling is a problem that’s on the rise in the community, and that it’s a growing problem amongst Hispanics who are not well-informed on the issue, as well as those who are older. Likewise, Angomas stated that he would like to see more resources, materials, and programs on the radio and on television, that effectively communicate the issue of problem gambling so that more prevention, care, and further analysis of the issue can take place.

Intervention and Treatment Support Director, Victor Ortiz, said, "As a social worker, I have seen many Latinos struggling with gambling problems. Language and cultural barriers often prohibit individuals from getting the help they need. I encourage all community organizations serving Latinos to learn about problem gambling and how it impacts both individuals and family members. As helping professionals, we can strengthen our communities by offering even more resources for help and supporting our neighbors in whatever challenges they may face.”

Here are some other common barriers to prevention and care, as outlined by NPGA and CLUES:

• Language
• Cultural taboos and characteristics
• Lack of research
• Lack of resources
• Beliefs about addiction and mental health
• Lack of bicultural and multilingual staff
• Lack of culturally competent evidence-based programs

That being said, we offer programs and services as well as a helpful list of resources in Spanish and English on our Latino Problem Gambling website. An example of these services, as per our Programs and Services page, include:

• Building Capacity of Treatment Providers – The Council offers a Mass. Problem Gambling Specialist (MAPGS) certificate program that serves Spanish-speaking clients, and offers tech-assistance to those groups. We also train prevention practitioners and clinicians to help prevent and treat gambling problems. The focus of our comprehensive trainings ranges from clinical methodologies, changing demographics of the Latino populations, Latino sub-populations, cultural characteristics, current trends, barriers, and strategies for effectively changing and retaining Latino clients in treatment. 

• Community Outreach – We make an effort to develop relationships and organizations by participating in cultural events, local festivals, educational activities, community mobilizations, and other social gatherings. We also distribute literature related to problem gambling so that we can begin informative dialogue about gambling behavior. Council Consultant, Cesar Angomas, has attended festivals such as the Puerto Rican Festival of MA and Lynn Latin Festival in order to provide outreach for the Council and inform people on gambling disorder and the services that we provide. 

• Congregation Assistance Program (CAP) – We collaborate with faith-based ministry teams to assist as resources for the community on addiction and addiction-related issues. Over the past few years, the CAP curriculum was adapted to focus on Latino communities. As the CAP Spanish-curriculum PowerPoint outlines: “Faith is at the heart of Latino communities. Congregations are places that people go to connect with their homelands and to build social networks. Faith-based groups have a long history of offering both guidance and support to neighborhoods by delivering human service programs. Because congregations already possess the human and spiritual resources to help, the CAP is a natural way for the Council to reach Latinos with problem gambling messages.”

•  Prevention-Specific Trainings and Tech-Assistance for Providers – We have onsite trainings for Latino organizations and organizations that seek to improve their capacity to deliver problem gambling preventions services. The trainings focus on the prevention of problem gambling, Latino cultural characteristics, strategies and techniques, and resources.

 

• Our Self-Help Guidebook  and brochures are also available in both Spanish and English and include thorough information on disordered gambling.

It is evident that Latinos need more information on problem gambling and addiction. The only way to help people experiencing problems with gambling is to establish channels of communication and educate society on what it means to have a gambling disorder. In this way, we can continue to provide education on the prevention and care of gambling disorder, and develop new materials to better help the Latino community. With that said, gambling disorders are not a culturally-exclusive issue, it can happen to anyone.

If you would like more information about our programs and services, or would like to find out how to get involved with the Council, please call our helpline in English (800.426.1234) or in Spanish (857.383.3558).

Book Review: The Compassionate Instinct

By Amanda Poggenburg, Program Specialist, The Massachusetts Council on Compulsive Gambling

 

In an effort for Council staff members to continue educating ourselves on problem gambling, each member chose a book on the topic to read and review. This week’s review comes from the Council Program Specialist, Amanda Poggenburg.

 

Amanda chose the book: The Compassionate Instinct.

 

The Compassionate Instinct is a compilation of articles from Berkley University of California’s Greater Good: The Science of Meaningful Life magazine that discuss the human capacity for compassion and empathy. The book begins by presenting articles that show the correlation between human and primate instincts towards others of their own kind; detailing instances where a human is presented with another in pain and is given the option to take that pain from the other (p. 13) or where a primate chooses to protect an injured, defenseless animal (p. 18). Another intriguing article discussed that compassion and empathy are not just felt in reality, but also for fictional characters in literary works and film (pp. 150-56).

The book is separated into three sections: “The Science of Human Goodness,” “Cultivating Goodness in Relationships,” and “Cultivating Goodness in Society and Politics.” The first section, “The Science of Human Goodness” seemed to set the stage for the rest of the book to explore how to release compassion within others. To relate science to compassion, one article discussed the kind of symmetry between compassion or forgiveness and revenge. The article initially presented two truths. The first truth stated that the desire for revenge is a normal and natural part of human nature, and the second truth stated that the capacity for forgiveness was as well. This presents the question of how one would choose which was appropriate or even do-able. A third truth was then presented that suggests that to be a more forgiving and less vengeful society, we need to change the world, not human nature. (pp.54-59). The acts of forgiveness and revenge depend on the current societal conditions in any given location.

One of the most interesting facts presented was that the act of helping someone causes the same neurological reactions in the brain that receiving rewards or experiencing pleasure do. It releases the hormone oxytocin (also caused by eating chocolate) when behaviors such as smiles and friendly body language are performed. Another interesting discussion presented was on empathy and inequality. It discussed society’s reliance on empathy to guide it, and that “without empathy, the very meaning of society is up for grabs” (p. 191).

The Compassionate Instinct is a book for everyone. It seeks to understand how and why people are compassionate in certain instances versus others. This is important in the work we do at the Mass. Council because our work and outcomes are based on empathy and compassion. We may not offer counseling or direct services, but through our helpline, we do provide compassion, and that makes all the difference in our world.

Citation:

Dacher Keltner, Jason Marsh, and Jeremy Adam Smith, The Compassionate Instinct: The Science of Human Goodness (New York, London: W. W. Norton & Company, 2010).

 

Gambling Disorder & the DSM-5

By Sasha C. Russell, Communications Program Specialist, The Massachusetts Council on Compulsive Gambling

The Diagnostic and Statistical Manual of Mental Disorders (DSM) has long been hailed as the clinician’s Bible. This past May, the American Psychiatric Association (APA) released the long-awaited Fifth Edition of the manual, better known as DSM-5.

After 19 years of using the DSM-IV as a guide to treating patients and medical billing, the APA has released an updated version to coincide with our ever evolving world. Some disorders have been either moved or redefined, and in some cases added to “Section III” for warranting more research.**  

The National Center for Responsible Gambling (NCRG) White Paper, The Evolving Definition of Pathological Gambling in the DSM-5, reports that what was once defined as an “Impulse Control Disorder Not Elsewhere Classified,” pathological gambling is now defined as a gambling disorder under the category of “Substance-Related and Addictive Disorders.”

According to an article by Mark Moran, “The addition of Gambling Disorder and its inclusion with substance-related disorders is the most prominent change” in the DSM-5. Moran quotes an explanation by the chair of the DSM-5 Work Group on Substance-Related and Addictive Disorders, Charles O’Brien, M.D., “The idea of a non-substance-related addiction may be new to some people, but those of us who are studying the mechanisms of addiction find strong evidence from animal and human research that addiction is a disorder of the brain reward system, and it doesn’t matter whether the system is repeatedly activated by gambling or alcohol or another substance. In functional brain imaging—whether with gamblers or drug addicts—when they are showed video or photograph cues associated with their addiction, the same brain areas are activated.” (Video)

Although the DSM-5 does not include more diagnostic criteria than the DSM-IV, the movement leaves Gambling Disorder as the sole claimer of the “Non-Substance-Related Disorders” section under Substance-Related and Addictive Disorders. Along with changing categories, there were some adjustments to the definition of a gambling disorder. Currently the DSM-5 outlines the diagnostic criteria for a gambling disorder as:

A.       Persistent and recurrent problematic gambling behavior leading to clinically significant impairment or distress, as indicated by the individual exhibiting four (or more) of the following in a 12-month period:

1.       Needs to gamble with increasing amounts of money in order to achieve the desired excitement.

2.       Is restless or irritable when attempting to cut down or stop gambling.

3.       Is often preoccupied with gambling (e.g., having persistent thoughts of reliving past gambling experiences, handicapping or planning next venture, thinking of ways to get money with which to gamble).

4.       Often gambles when feeling distress (e.g., helpless, guilty, anxious, depressed).

5.       After losing money gambling, often returns another day to get even (“chasing” one’s losses).

6.       Lies to conceal the extent of involvement with gambling.

7.       Has jeopardized or lost a significant relationship, job, or educational career opportunity because of gambling.

8.       Relies on others to provide money to relieve desperate financial situations caused by gambling.

B.       The gambling behavior is not better explained by a manic episode.

 The criteria is essentially the same as in the DSM-IV, however, as the NCRG pointed out, there are some changes to the wording of each criterion and the DSM-5 has omitted a past criteria. Wording changes include the following:

 

      DSM-IV                                                                     DSM-5

      “Is preoccupied with gambling”                                 “Is often preoccupied with gambling”

      “Gambles as a way to escape from problems”         “Gambles when feeling distressed”

The omitted criterion reads, “Has committed illegal acts such as forgery, fraud theft or embezzlement to finance gambling.” The DSM-5 Work Group felt that any illegal acts would fall under “Lies to conceal the extent of involvement with gambling.” NCRG explains the reasoning behind this decision as, “no studies have found that assessing criminal behavior helps distinguish between people with a gambling disorder and those without one.”

The importance of these changes and this reclassification of the disorder is the hope that clinicians will have an easier time diagnosing and treating persons who are having problems with gambling. Classifying gambling disorder as a behavioral addiction will also be helpful in bringing the issue and surrounding elements to light in the public eyes – raising awareness and lowering stigma.

This is the beginning of an exciting era of change. We will continue to update you as we learn more about DSM-5 as it relates to Gambling Disorder.

 

 

 

**On a note about the above mentioned “Section III” in regards to gambling disorder, Moran, in APA’s Psychiatric News explained, “Section III of DSM-5 is not an “appendix,” but includes tools to enhance diagnosis, as well as models for an evolving DSM of the future.” As it relates to the field of problem gambling, Internet Gaming Disorder was placed in Section III as “a condition warranting more clinical research and experience before it might be considered for inclusion in the main book as a formal disorder.” (Video) This is an especially important idea with federal government having what’s informally known as the King Bill being reviewed. This bill would not only legalize internet gambling, but allow the government to hold jurisdiction over internet gambling. Several bills have also surfaced in gambling expansion discussions in Massachusetts. (Read my past blog about Internet Gambling; Read the Mass. State Lottery’s Online Products Task Force Report).