Department of Risk Management and Insurance, Robinson College of Business, Georgia State University, Atlanta, GA, USA.
School of Economics, University of Cape Town, Cape Town, South Africa.
J Gambl Stud. 2018 Mar;34(1):225-253. doi: 10.1007/s10899-017-9707-1.
We study Danish adult gambling behavior with an emphasis on discovering patterns relevant to public health forecasting and economic welfare assessment of policy. Methodological innovations include measurement of formative in addition to reflective constructs, estimation of prospective risk for developing gambling disorder rather than risk of being falsely negatively diagnosed, analysis with attention to sample weights and correction for sample selection bias, estimation of the impact of trigger questions on prevalence estimates and sample characteristics, and distinguishing between total and marginal effects of risk-indicating factors. The most significant novelty in our design is that nobody was excluded on the basis of their response to a 'trigger' or 'gateway' question about previous gambling history. Our sample consists of 8405 adult Danes. We administered the Focal Adult Gambling Screen to all subjects and estimate prospective risk for disordered gambling. We find that 87.6% of the population is indicated for no detectable risk, 5.4% is indicated for early risk, 1.7% is indicated for intermediate risk, 2.6% is indicated for advanced risk, and 2.6% is indicated for disordered gambling. Correcting for sample weights and controlling for sample selection has a significant effect on prevalence rates. Although these estimates of the 'at risk' fraction of the population are significantly higher than conventionally reported, we infer a significant decrease in overall prevalence rates of detectable risk with these corrections, since gambling behavior is positively correlated with the decision to participate in gambling surveys. We also find that imposing a threshold gambling history leads to underestimation of the prevalence of gambling problems.
我们研究丹麦成年人的赌博行为，重点是发现与公共卫生预测和政策经济福利评估相关的模式。方法创新包括对形成性和反射性结构进行测量，对发展赌博障碍的前瞻性风险进行估计，而不是对被错误地诊断为阴性的风险进行估计，分析时要注意样本权重和对样本选择偏差的修正，对触发问题对患病率估计和样本特征的影响进行估计，以及区分风险指示因素的总效应和边际效应。我们设计中最显著的新颖之处在于，没有人因为对以前赌博史的“触发”或“门户”问题的反应而被排除在外。我们的样本由 8405 名成年丹麦人组成。我们向所有受试者发放了成人焦点赌博筛查问卷，并估计了赌博障碍的前瞻性风险。我们发现，87.6%的人没有可检测到的风险，5.4%的人有早期风险，1.7%的人有中期风险，2.6%的人有晚期风险，2.6%的人有赌博障碍。校正样本权重和控制样本选择对患病率有显著影响。尽管这些“风险人群”的估计比例明显高于传统报告，但我们推断，通过这些修正，可检测风险的总体患病率显著下降，因为赌博行为与参与赌博调查的决定呈正相关。我们还发现，设定一个赌博史阈值会导致对赌博问题的患病率的低估。
