GAI Research

 

Abstract

The Gambler Addiction Index (GAI) is an
adult gambler assessment test that accurately measures gambler risk of gambling
addiction, suicide, substance (alcohol and drugs) abuse, emotional and mental
health problems. There were 190 adult gamblers included in this study.
Reliability analyses showed that all seven GAI scales had very high reliability
coefficient alphas of between .89 and .98. GAI scales were validated in several
tests of validity. Discriminant validity was shown by significant differences on
GAI Alcohol and Drugs scales between first and multiple offenders. The Gambler
Scale correctly identified 100% of clients who admitted they were problem
gamblers. The Alcohol and Drugs Scales correctly identified 100% of the
respondents who had alcohol and drug problems. The Suicide Scale correctly
identified all of the clients who admitted suicide ideation and the Attitude
Scale identified all clients who admitted attitude and resistance problems. GAI
classification of gambler risk was shown to be very accurate. All GAI scale
scores were within 1.6% of predicted risk range percentile scores. This study
demonstrated that the GAI is a reliable, valid and accurate adult gambler
assessment test.

 

Gambler Addiction Index: Gambler Assessment

Introduction

With the advent and subsequent increase
in casinos on Indian Reservations in this country, gambling addiction has become
a social issue and concern. Many states require provisions for programs to aid
gambler addiction in gambling pacts with Native American tribes who run casinos.
An important step in dealing with increased gambling addiction is screening and
assessment of adult gamblers to assess severity of addiction. Gamblers can be
screened for problems and directed to appropriate agencies for help, treatment
and rehabilitation. The Gambler Addiction Index is an adult gambler assessment
or screening test. Screening gamblers to identify problems facilitates placement
of clients into appropriate supervision levels, intervention programs and
treatment. Accurate and reliable gambler risk and needs assessment is essential
for placement of gamblers in programs to help them find the right path to
recovery.

The Gambler Addiction Index (GAI) is a
multidimensional test that was developed to meet the needs of adult gambler
screening and assessment. GAI scales measure problem gambling tendencies
(Gambler Scale), alcohol and drug abuse severity (Alcohol & Drugs Scales),
suicide potential (Suicide Scale), resistance attitudes (Attitude Scale) and
emotional or mental health problems (Stress Coping Abilities Scale). In
addition, the Truthfulness Scale measures respondent truthfulness while
completing the test. Clients who deny or minimize their problems are detected by
the Truthfulness Scale. Truthfulness Scale scores are used to truth-correct
other scale scores. The present study investigated the reliability, validity and
accuracy of the Gambler Addiction Index.

Resistance, emotional, mental health
and stress coping abilities are personality factors that are relevant to gambler
risk. These factors are measured by the GAI. Personality, attitude and
behavioral factors, often referred to as "dynamic variables," are capable of
change and are amenable to intervention and treatment. Positively changing
clients’ personality, attitudes and behavior can lead to behavioral change.
Identification of problem prone clients is the first step in directing gamblers
to appropriate programs aimed at helping them to positively change their
behavior.

For ease in interpreting gambler risk,
the GAI scoring methodology classifies respondent scale scores into one of four
risk ranges: low risk (zero to 39th percentile), medium risk (40 to
69th percentile), problem risk (70 to 89th percentile),
and severe problem risk (90 to 100th percentile). By definition the
expected percentages of respondents scoring in each risk range (for each scale)
is: low risk (39%), medium risk (30%), problem risk (20%), and severe problem
risk (11%). Clients who score at or above the 70th percentile are
identified as having problems. Clients scale scores at or above the 90th
percentile identify severe problems. The accuracy of the GAI in terms of risk
range percentages was examined in this study.

This study validates the GAI in a
sample of adult gamblers who were tested at court referral programs. Two methods
for validating the GAI were used in this study. The first method (discriminant
validity) compared first and multiple offenders’ scale scores. Multiple
offenders were offenders with two or more arrests and first offenders had one or
no arrest. It was hypothesized that statistically significant differences
between multiple and first offenders would exist and GAI scales would
differentiate between first and multiple offenders. Multiple offenders would be
expected to score higher on GAI scales because having a second arrest is
indicative of serious problems.

The second validation method
(predictive validity) examined the accuracy at which the GAI identified "problem
gamblers," i.e., clients with gambling addiction problems, suicide prone
clients, inappropriately resistant and uncooperative clients, problem drinkers
and problem drug abusers. Tests that measure severity of problems should be able
to predict if clients have problems by the magnitude (severity) of their scores.
Accurate tests differentiate between problem and non-problem clients. An
inaccurate test, for example, may too often call non-problem drinkers problem
drinkers or vice versa. Responses to test items obtained from the clients’
served as criterion measures.

Having been in alcohol treatment
identifies clients as having an alcohol problem. It is acknowledged that there
are some clients who have an alcohol problem but have not been in treatment.
Nevertheless, clients who have been in alcohol treatment would be expected to
score in the Alcohol Scale’s problem range. Similarly, having been in drug
treatment identifies clients who have drug problems. In regards to gambling
addiction, suicide and resistance, clients direct admissions of problems were
used as the criteria.

For the predictive validity analyses
clients were separated into two groups, those who had treatment or admitted
problems (problem group) and those who did not have treatment or did not admit
to problems (no problem group). Then, client scores on the relevant GAI scales
were compared. It was predicted that problem group clients would score in the
problem risk range (70th percentile and above) on the relevant GAI
scales. Non-problem was defined in terms of low risk scores (39th
percentile and below). The percentage of problem group clients who scored in the
70th percentile range and above is a measure of how accurate GAI
scales are. High percentages (above 90%) of problem group clients who had
problem risk scores would indicate the scales are accurate. Because criterion
measures were gotten from the GAI database, a lack of suitable criterion
measures prevented carrying out predictive validity analyses on the other two
GAI scales. The test items used in these analyses were, "I have attended
Alcoholics Anonymous (AA) or Rational Recovery (RR) meetings because of my
drinking." "I have been in a chemical dependency program for my drug problem."
"I go to Gamblers Anonymous (GA) meetings because of my gambling." "I am
resentful of authority and resistant to people in general." and "To be honest, I
am suicidal."

Method

Subjects

There were 190 adult gamblers tested
with the GAI. There were 142 males (74.7%) and 48 females (25.3%). The ages of
the participants ranged from 19 through 40 as follows: 20 & under (12.8%); 21-30
(41.4%); 31-40 (27.6%); 41-50 (12.2%); 51-60 (4.3%) and 60 & over (1.6%). The
demographic composition of participants was as follows. Race/Ethnicity:
Caucasian (80.9%); Black (6.9%), Hispanic (2.1%), Native American (8.5%) and
Other (1.6%). Education: Eighth grade or less (1.6%); Some high school (14.8%);
High school graduate/GED (43.8%); Some college (25.8%) and College graduate
(3.8%). Marital Status: Single (51.6%); Married (21.8%); Divorced (20.2%) and
Separated (6.4%).

Over 79 percent of the participants
were arrested two or more times. Over 43 percent of the clients had five or more
arrests. Two-thirds (66.3%) of the clients had been placed on probation one or
more times. One-third (34.7%) of the participants had two or more alcohol
arrests and 20.9 percent had two or more drug arrests.

Procedure

Participants completed the GAI as part
of gambler screening and assessment in court referral settings. The GAI contains
seven measures or scales. These scales are briefly described as follows. The
Truthfulness Scale measures the truthfulness, denial and problem minimization of
the respondent while taking the GAI. The Gambler Scale measures gambler interest
and involvement in gambling. This scale extends from normal to pathological. The
Alcohol Scale measures severity of alcohol use or abuse. The Drugs Scale
measures severity of drug use or abuse. The Attitude Scale measures the
gambler’s outlook (cooperative versus resistant) toward help and assistance. The
Suicide Scale identifies suicide prone gamblers and measures the severity of
their distress. The Stress Coping Abilities Scale measures ability to cope with
stress. A score at the 90th percentile or higher on this scale
identifies established emotional and mental health problems.

Results and Discussion

The inter-item reliability coefficient
alphas for the seven GAI scales are presented in Table 1. All scales were highly
reliable. Reliability coefficient alphas for all GAI scales were at or above
0.90. These results demonstrate that the GAI is a very reliable adult gambler
assessment test.

Table 1. Reliability of the GAI (N=190)

GAI S

cale

Coefficient Alpha

Significance Level

Truthfulness
Scale

.90

p<.001

Gambler Scale

.97

p<.001

Suicide Scale

.91

p<.001

Alcohol Scale

.95

p<.001

Drugs Scale

.94

p<.001

Attitude Scale

.90

p<.001

Stress Coping
Abilities

.98

p<.001

Discriminant validity results are
presented in Table 2. In these analyses the answer sheet items "Number of
alcohol arrests" and "Number of drug arrests" were used to define first
offenders (one or no arrest) and multiple offenders (2 or more arrests). T-test
comparisons were used to study the statistical significance between the offender
groups. "Number of alcohol arrests" was used for the Alcohol Scale, which had
125 first offenders and 65 multiple offenders (2 or more arrests). "Number of
drug arrests" was used for the Drugs Scale, which had 151 first offenders and 39
multiple offenders (2 or more arrests).

Table 2. Comparisons between first
offenders and multiple offenders (N=190).

GAI

Scale

First Offenders

Mean

Multiple Offenders

Mean



T-value

Level of Significance

Alcohol Scale

6.97

26.38

t = 25.40

p<.001

Drugs Scale

10.44

24.78

t = 17.48

p<.001

Table 2 shows that mean (average) scale
scores of first offenders were significantly lower than scores for multiple
offenders on GAI Alcohol Drugs Scales. As expected, multiple offenders scored
significantly higher than did first offenders. GAI substance abuse severity
measurement scales differentiated between first offenders and multiple
offenders. These results support the validity of the GAI Alcohol and Drugs
Scales. The other GAI scales did not have relevant criterion measures to define
offender groups and were not included in this analysis.

Correlation coefficients between
respondents’ criminal history and related GAI scales are presented in Table 3.
Statistically significant correlation coefficients between GAI Alcohol and Drugs
scales and alcohol and drug arrests also validate GAI scales. GAI scales that
measure alcohol and drug problems were expected to be correlated with alcohol
and drug arrests. Participants’ criminal histories were obtained from GAI answer
sheets that were completed by the participants.

Table 3. Relationships between Criminal
History Variables and Related GAI Scales

Criminal History
Variables

Alcohol

Scale

Drugs

Scale

Total number of arrests

.21*

.33**

Times on probation

.35**

.33**

Alcohol arrests

.63**

.10

Drug arrests

.12

.58**

Note: Significance level * p<.01, ** p<.001.








 







Total number of arrests and number of
times on probation are significantly correlated with the Alcohol and Drugs
scales. The Alcohol Scale is significantly correlated with alcohol-related
arrests. The Drugs Scale is significantly correlated with drug-related arrests.
These results are in agreement with the discriminant validity results reported
above. Significant correlations with alcohol and drug arrests support the
validity of the Alcohol and Drugs Scales, respectively. The correlations with
alcohol and drug arrests suggest that gamblers use either alcohol or drugs by
not both. The magnitude of the correlation coefficients are moderate and suggest
that criminal history variables alone do not predict gambler problems. GAI
scales, that measure problem-prone behaviors, are needed for accurate prediction
of gambler problems.

Predictive validity results for the
correct identification of problem behavior (gambling addiction, suicide
tendencies, drinking and drug abuse problems) are presented in Table 4. Table 4
shows the percentages of respondents who had or admitted to having problems and
who scored in the problem risk range. For the Alcohol and Drugs Scales criteria,
problem behavior means the client had alcohol or drug treatment. For the
Gambler, Suicide and Attitude Scales the client attended Gamblers Anonymous,
admitted suicide ideation and admitted resistance problems, respectively. In
these analyses scale scores in the Low risk range (zero to 39th
percentile) represent "no problem," whereas, scores in the Problem and Severe
Problem risk ranges (70th percentile and higher) represent gambling,
suicide, resistance, alcohol and drug problems.

The Alcohol Scale is very accurate in
identifying respondents who have alcohol problems. There were 49 clients who had
attended Alcoholics Anonymous and these clients were classified as problem
drinkers. All 49 clients, or 100 percent, had Alcohol Scale scores at or above
the 70th percentile. The Alcohol Scale correctly identified all of the clients
categorized as problem drinkers. This result validates the Alcohol Scale. It is
likely that some clients have alcohol problems but have not attended Alcoholics
Anonymous. For these individuals scoring at or above the 70th
percentile on the Alcohol Scale alcohol treatment is recommended.

The Drugs Scale was also very accurate
in identifying respondents who have drug problems. There were 32 clients who had
been in drug treatment, all 32 clients, or 100 percent, had Drugs Scale scores
at or above the 70th percentile. This result strongly substantiates
the accuracy of the Drugs Scale.

 

Table 4. Predictive Validity of the GAI

GAI

Scale

Correct Identification of Problem
Behavior

Alcohol

100%

Drugs

100%

Gambler

100%

Suicide

100%

Attitude

100%

The Gambler Scale accurately identified
clients (100%) who admitted gambling problems. Clients who attended Gamblers
Anonymous scored in the problem range. The direct admission of a gambling
problem validates the Gambler Scale. The Suicide Scale identified all 8 client
(100%) who admitted being suicidal. The Attitude Scale identified all (10
individuals or 100%) of the clients who admitted they were resistant to
authority and staff help. The Alcohol and Drugs Scale accurately identified
clients who had alcohol and drug problems. These results strongly support the
validity of the GAI Gambler, Suicide, Attitude, Alcohol and Drugs Scales. The
other two GAI scales were not included in these analyses because of a lack of
direct admission or other criterion measure within the GAI database.

GAI risk range percentile accuracy is
presented in Table 5. Risk range percentile scores are derived from scoring
equations based on clients’ pattern of responding to scale items and criminal
history, when applicable. There are four risk range categories: Low Risk (zero
to 39th percentile), Medium Risk (40 to 69th percentile),
Problem Risk (70 to 89th percentile) and Severe Problem or Maximum
Risk (90 to 100th percentile). Risk range percentile scores represent
degree of severity. The higher the percentile score is the higher the severity
of the respondent’s problems.

Analysis of the accuracy of GAI risk
range percentile scores involved comparing the client’s obtained risk range
percentile scores to predicted risk range percentages as defined above. The
percentages of clients expected to fall into each risk range are: Low Risk
(39%), Medium Risk (30%), Problem Risk (20%) and Severe Problem or Maximum Risk
(11%). These percentages are shown in parentheses in the top row of Table 5. The
actual percentage of clients falling in each of the four risk ranges, based on
their risk range percentile scores, was compared to these predicted percentages.
The differences between predicted and obtained are shown in parentheses.

Table 5. Accuracy of GAI Risk Range
Percentile Scores

Scale

Low Risk

(39% Predicted)

Medium Risk (30% Predicted)

Problem Risk (20% Predicted)

Severe Problem (11% Predicted)

Truthfulness

39.5

(0.5)

30.5

(0.5)

19.7

(0.3)

10.3

(0.7)

Gambler

38.5

(0.5)

32.0

(2.0)

19.0

(1.0)

10.5

(0.5)

Alcohol

37.2

(1.8)

31.7

(1.7)

19.5

(0.5)

11.6

(0.6)

Drugs

38.9

(0.1)

30.0

(0.0)

19.5

(0.5)

11.6

(0.6)

Attitude

37.4

(1.6)

31.0

(1.0)

20.5

(0.5)

11.1

(0.1)

Suicide

38.7

(0.3)

32.3

(2.3)

18.2

(1.8)

10.8

(0.2)

Stress Coping

38.9

(0.1)

30.0

(0.0)

20.0

(0.0)

11.1

(0.1)

As shown in Table 5, GAI scale scores
are very accurate. The objectively obtained percentages of participants falling
in each risk range are very close to the expected percentages for each risk
category. All of the obtained risk range percentages were within 2.3 percentage
points of the expected percentages and most (22 of the 28) were within 1.0
percentage points. These results demonstrate that the GAI scale scores
accurately classify gambler risk.

 

Conclusion

This study demonstrates that accurate
gambler assessment is achieved with the Gambler Addiction Index (GAI). Results
corroborate and support the GAI as an accurate assessment or screening test for
adult gamblers. The GAI accurately measures gambler risk of gambling addiction,
suicide, substance (alcohol and drugs) abuse, resistance behavior, emotional and
mental health problems. In short, the GAI provides a wealth of information
concerning gamblers’ adjustment and problems that contributes to understanding
the gamblers.

Reliability results demonstrated that
all seven GAI scales are highly reliable. Reliability is necessary in gambler
assessment or screening tests for accurate measurement of gambler risk. Tests
cannot be valid or accurate without being reliable. Validity analyses confirm
that the GAI measures what it purports to measure, that is, gambler risk.
Results demonstrate that repeat offenders exhibit more problem-prone behavior
than first offenders. Multiple offenders (having 2 or more arrests) scored
significantly higher than first offenders (discriminant validity). The GAI
accurately identified gamblers who have problems. And, obtained risk range
percentages on all GAI scales very closely approximated predicted percentages.
These results strongly support the validity of the GAI.

GAI results provide important
risk/needs assessment for courts to make informed decisions regarding gambler
sentencing options. Problem-prone individuals exhibit many characteristics that
are identified with the GAI. Relationships between gamblers’ criminal history
variables and GAI scale scores demonstrate that the GAI measures relevant
behaviors that identify gamblers as problem-prone. Identification of these
problems and prompt intervention can reduce a gambler’s risk of gambling
addiction. The GAI facilitates understanding of gambling addiction, suicide
tendencies, substance abuse, resistant behavior, and emotional and mental health
problems. GAI results also provide an empirical basis for recommending
appropriate supervision level, intervention and treatment programs.

Many of the exacerbating conditions
that act as problem-prone triggering mechanisms are also identified by the GAI.
The Alcohol and Drugs Scales measure substance abuse problems. The Stress Coping
Abilities scales measure emotional and mental health problems. The GAI is an
important tool for decision making regarding gambler supervision level,
rehabilitation, and treatment. Courts can direct gamblers to appropriate
programs to affect behavioral change. Positively changing gambler behavior can
lead to recovery from gambling addiction.

 

 

Donald D. Davignon, Ph.D.

Senior Research Analyst



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