OBJECTIVES: This study developed prevalence estimates of gambling-related disorders in the United States and Canada, identified differences in prevalence among population segments, and identified changes in prevalence over the past 20 years. METHODS: A meta-analytic strategy was employed to synthesize estimates from 119 prevalence studies. This method produced more reliable prevalence rates than were available from any single study. RESULTS: Prevalence estimates among samples of adolescents were significantly higher than estimates among samples of adults for both clinical (level 3) and subclinical (level 2) measures of disordered gambling within both lifetime and past-year time frames (e.g., 3.9% vs 1.6% for lifetime estimates of level 3 gambling). Among adults, prevalence estimates of disordered gambling have increased significantly during the past 20 years. CONCLUSIONS: Membership in youth, treatment, or prison population segments is significantly associated with experiencing gambling-related disorders. Understanding subclinical gamblers provides a meaningful opportunity to lower the public health burden associated with gambling disorders. Further research is necessary to determine whether the prevalence of disordered gambling will continue to increase among the general adult population and how prevalence among adolescents will change as this cohort ages.

* A list of these studies is available at www.hms.harvard.edu/doa/html/cjph.htm. † If a study used multiple instruments to assess disordered gambling among its sample, each reported estimate was weighted so that the aggregate weight of the study's estimates was equal to 1.0 within each time frame (e.g., 2 past-year estimates from a single study sample would be weighted 0.5 each, 3 past-year estimates would be rated 0.33 each).

This article reviews the extant published and unpublished studies that estimate the prevalence of adolescent gambling problems in North America. The nine nonduplicative studies identified by our literature search included data collected from more than 7700 adolescents from five different regions of the United States and Canada. In addition to comparing the conceptual and methodological differences that exist among these studies, this article employed a meta-analytic strategy to synthesize prevalence estimates from the existing studies. This analysis revealed that within a 95 percent confidence interval, between 9.9% and 14.2% of adolescents are at risk of developing or returning to serious gambling problems. Similarly, between 4.4% and 7.4% of adolescents exhibit seriously adverse compulsive or pathological patterns of gambling activity. Finally, the discussion proposes a generic multi-level classification scheme to reconcile the divergent classification methods and data reporting strategies. This new multi-level approach to reporting gambling prevalence will facilitate interstudy comparisons among existing estimates of gambling prevalence and help to provide a general data reporting system for future research.

Problems related to intemperate Internet use are examined within the conceptual framework of addiction. It is argued that empirical support for the construct validity of computer addiction has yet to emerge, that defining the construct as a unique psychiatric disorder is therefore premature, and that, in most cases, excessive computer use may be symptomatic of other, more primary disorders. Greater caution and rigor are urged in investigating and treating problems related to intemperate computer use.

From an eligible population of 9,943 casino employees, 6,067 volunteered to participate in this study. Of this sample, 1,176 provided data at 3 observation points approximately 12 months apart. Using the South Oaks Gambling Screen (SOGS; H. R. Lesieur & S. B. Blume, 1987) and the CAGE (J. A. Ewing, 1984) questionnaire, the authors prospectively examined the prevalence and patterns of alcohol and gambling problems among those employees. Among the casino employees with gambling and drinking problems, a segment displayed the capacity to diminish those problems even when the difficulties had reached disordered levels. The authors also examined the comorbidity of gambling and drinking as well as the relationships among changes in SOGS scores and CAGE scores and changes in demographic and biological variables. The women were more likely to decrease their problem-drinking scores, but not their gambling scores, when compared with the men. In addition, 2 key variables (i.e., disabling depression and dissatisfaction with one's personal life) emerged as predictors of transitions to healthier levels of disordered gambling. The authors cautiously suggest, in light of the results taken together, that more fluctuation is associated with gambling and drinking problems than previously thought and that the conventional wisdom about disordered gambling as "always progressive" needs reconsideration.