Pathological Gambling: A Comparison of Gambling at German-style Slot Machines and "Classical" Gambling Thomas F a b i a n
Department of Social Work Hochschule fiir Technik, Wirtschaft und Kultur Leipzig (FH), Germany
German-style slot machines and related legal issues are described. On the basis of a survey on 437 members of self-help groups (Gamblers Anonymous) in Germany, slot machine gamblers were compared with casino gamblers on such variables as sociodemographic data, gambling behaviour, financial expenditure, emotional experience while gambling, symptoms of pathological gambling, psychosocial consequences and gambling related delinquency. The casino gamblers' gambling behaviour is financially more extensive. There were similarities regarding the emotional intensity of the gambling experience. However the casino gamblers show more pronounced symptoms of pathological gambling and the psychosocial consequences of their gambling behaviour are more severe. In spite of these differences, the data show that for young people slot machines can be as stimulating and therefore as dangerous as casino gambling. The young slot machine gambler runs a similar risk of acquiring a pathological gambling habit as the casino gambler.
INTRODUCTION I n G e r m a n y s l o t - m a c h i n e s w i t h m o n e y - w i n n i n g c h a n c e s for t h e g a m b l e r ( G e r m a n - s t y l e slot-machines) m a y be installed in a m u s e m e n t
I would like to thank Dr. Gerhard Meyer for his support and his commentson the first draft of this article which is based on data from a research project led by him. Address correspondenceand reprint requests to Prof. Dr. Thomas Fabian, Hochschule ffir Technik, Wirtschaft und Kultur Leipzig (FH), Fachbereich Socialwesen, PF 66, D-04251 Leipzig, Federal Republic of Germany.
Journal of GamblingStudies Vol. 11(3), Fall 1995 9 1995 Human Sciences Press, Inc.
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arcades and pubs. These so-called "entertainment slot-machines with chances of winnings" are not defined as games of chance by law. G a m e s of chance may be organized only under state supervision and control, the classical slot-machines are therefore allowed only in state-run casinos.
Legal Issues There are a number of government regulations concerning "entertainment slot-machines with chances of winnings," which are m e a n t to keep winnings and losses at a low rate and thereby exclude the possibility of substantial sums being won or lost. The purpose of these regulations is to distinguish between slot-machines and actual games of chance and allow their commercial operation. The provisions of the Gambling Decree for slot machines are as follows: --maximum --maximum --minimum --minimum
stake per game: 0.30 D M ($1 U.S. -- 1.60 D M ) , winnings per game: 3.00 D M , running time per game: 15 seconds, rate of money paid out: 53.4%.
The decree permits the installation of no more than ten slotmachines in amusement arcades (on an area of at least 150 m 2) and of no more than two slot-machines in pubs. Persons under the age o f 18 are not allowed admittance to amusement arcades. These legal regulations are meant to protect the gambler from an "excessive exploitation of the gambling urge" (5 33 ft. Trading Regulations).
The New Generation of German-style Slot Machines However, by combining gambling sequences the slot machine industry succeeded in introducing new gambling systems (special games and games involving extra risks) which circumvent the intentions of the law. In the special gambling series (with up to 200 special games) about every second game yields the m a x i m u m winning of 3.00 D M . Winnings can therefore add up to as much as 240.00 D M , a sum which for gamblers with low income represents a substantial value. As a rule the series are set off on the three discs of the slot-machine after a
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combination of certain symbols has appeared. The special-risk game allows winnings of the basic game to be doubled, step by step, by pressing a button. In this way up to 50 special games can be played. The gamblers can therefore stake more (i.e. run higher risks) than laid down by the law. By pressing "stop", "start" and "risk" buttons gamblers are under the illusion that they take an active part in the game, although in reality they cannot influence the result, because it is already determined by the slot machine's electronic programme. With an average loss of 33.60 D M per hour (max. 72.00 DM) at one machine and the possibility o f gambling at several machines simultaneously, the losses can add up to sums which put the gamblers' property at risk. The entertainment slot machines with money-winning chances therefore fulfil the criteria of a game of chance, i.e. they involve the risk of substantial financial losses and the possibility of substantial winnings.
Political Debate and "Voluntary Self-restricting Agreements ~ by the Slotmachine Industry After the expansion of amusement arcades in the eighties (in 1991 there were approximately 6,500 amusement arcades in Germany, not counting the former German Democratic Republic), obvious "maldevelopments" and the public debate about "pathological gambling," the German Bundestag (lower house of Parliament) called for measures which would lessen the incentive for gamblers on slot machines (1991: 175,000). Such measures were taken by the slot machine industry in the form of "voluntary self-restricting agreements" and have been in force since the 4th of November 1990 (BT Mitteilung 11/6224) (see Meyer, 1992): --limitation of special games which allow cumulative winnings to 150 games, --limitation of the coin store to a m a x i m u m of 50 DM, --limitation of the risk series to 50 special games, -- introduction of a compulsory break of three minutes after one hour's uninterrupted gambling, --warning notice on the front panel of the slot machines (Figure
1),
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Figure 1 Warning Notice by the Slot-Machine I n d u s t r y
":Jugendschutz- ist keine L6sung Gesetz w 8" bei pers6nlichen Problemen
"N' lnfo: ortsta,',0130 3727
The two warnings of the sign read: "Not under the age of 18 according to the law." and "Excessive playing is no solution to personal problems."
--provision of information material on the dangers of frequent gambling, --prevention of simultaneous gambling on more than two machines, --restriction of advertisement for slot machines. However, the preventive effect of these measures is probably negligible, since gambling on slot machines retains the characteristics of games of chance, i.e. substantial winnings and losses. Besides, many operators do not keep to the agreements (BT Mitteilung 1213232). In March 1993 the Bundesrat (upper house of Parliament) approved a motion of the Ministery of Trade and Commerce for an increase of the stake and maximum winnings to 0.40 DM and 4.00 DM, respectively, which amounts to an increased incentive for gambling (Bundesrat Mitteilung 126/93). At the same time the Bundesrat
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asked the Federal Government for an amendment to the Gambling Decree which would prohibit, or at least greatly restrict, the possibility of winnings by special and extra risk games on slot machines. However, while the increase of stakes and winnings came into force in M a y 1993, the realization of the second resolution, which would truly be of a preventive nature, is still "up in the air."
German-style Slot Machines and Pathological Gambling The development of slot machines into games of chance and the consequent boom of amusement arcades have attracted about 10% of the population (approximately 4.6 million) as active gamblers, i.e. they gambled on slot machines during the past three months (Bfihringer, 1992). T h e y are especially frequented by young people (18-30 years of age) with low incomes (Rohwedder, 1987; Bfihringer & Konstanty, 1992). For this group of people, gambling on slot machines means putting their property at stake. For them, slot machines have the typical attractions of games of chance, like roulette has for financially better-off citizens. From a psychological point of view, there exists a pronounced addiction potential in gambling on slot machines because of the following structural characteristics (see also Griffiths, 1993): --rapid gambling sequence (high frequency of events) and short pay out intervals - wide variety of stakes a n d chances of winning (referring to the extra risk and special games system) - t h e attractive relation between the probability of winning on one hand and the amount of winnings (for persons with low incomes) as well as the number of small winnings on the other hand --the active involvement of the gambler in the course of the game (by pressing "stop", "start" and "risk" buttons) --the low stakes (0.30 or 0.40 D M per game) One consequence of this is that slot machine gamblers may develop pathological gambling behaviour. So far there are no reliable data on the prevalence of such behaviour. Existing estimates of the n u m b e r of gamblers concerned differ significantly. While pathological
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gamblers in self-help groups estimate the number of pathological gamblers as 1,000,000, B/ihringer (1992) (see also B/ihringer & Konstanty, 1992) estimated a lower figure of 30,000 with about 8,000 "frequent gamblers on slot machines under subjective stress" among them. However, a study of slot machine gamblers in amusement arcades showed that at times 15 % of all gamblers were under strong emotional stress (Herbst, 1993). Doubts about the reliability of these estimates arise when the demand by slot machine gamblers for therapy is taken into account. In 1988, for instance, approximately 4,900 gamblers, who only gambled on slot machines, went to an out-patient institution which provided advice and treatment (Strobl, 1991); this would mean that during that year more than 61% of the gamblers had out-patient therapy. In comparison: in 1991 approximately 79.,000 of the estimated 2.4 million alcoholics were treated in out-patient institutions, i.e. 3.3% of all concerned asked for therapy. In general, it takes several years before problem gamblers go to an advice centre. At first, it is always possible to find solutions for financial problems, therefore seeking help is put off. Psychosocial harm as a consequence of excessive gambling becomes evident only relatively late. In addition, pathological gamblers are less willing to admit that they need treatment than alcoholics or heroin addicts. This is because pathological gambling is perceived as having no physiological causes and involving hardly any physical harm. On the basis of the demand for therapy in out-patient institutions and through comparison with addictions to drugs and alcohol, the number of gamblers in Germany who are in need of advice and treatment is estimated at approximately 200,000. Both in out-patient and in-patient treatment centres for pathological gamblers as well as in self-help groups of "Gamblers Anonymous," gamblers who only gamble on slot machines represent the biggest group (Klepsch, Hand, Wlazlo, Fischer, Friedrich & Bodek, 1989; Meyer, 1989; Kellermann & Soest, 1992; Schwarz & Lindner, 1992). Their proportion varies between 59% and 83 %. The following question therefore arises. If slot machines may be classified as games of chance in the same way as the classical ones like roulette or blackjack, do they subsequently involve a similar risk to develop a pathological gambling behaviour? This question was examined in the following study.
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METHOD
Sample 437 gamblers from 54 self-help groups were interviewed. The mean age of the mainly male (95%) interviewees was 31 years. In comparison with the age structure of the overall population the age group 20 to under 40 is overrepresented in this sample. The male interviewees had a better education, with respect to profession and monthly net income. There were no substantial divergences from the overall population. 91.6 % of the interviewees met at least four of the nine diagnostic criteria of the DSM-III-R (APA, 1987) for pathological gambling.
Procedure
All 54 existing self-help groups for gamblers in the Federal Republic of Germany were contacted in 1987 and the group members were interviewed with standardized instruments. These consisted of a comprehensive questionnaire about a wide range of different aspects of gambling including the diagnostic criteria of the DSM-III-R which was developed for the purpose of this investigation, a list of adjectives for self-description of the emgtional state while gambling (following Janke & Debus, 1978) and questions concerning socio-demographic data. The instruments were tested with a probabilistic scaling procedure (Mokken, 1971). A detailed description of all instruments has been published in a report of the research project (Meyer, 1989). Group comparisons (t-test, Chi squared-test) were made regarding gambling behaviour, symptoms of pathological gambling and psychosocial consequences between those interviewees who reported to have gambled only at slot machines and those who reported to also have gambled in casinos run by the state or illegal gambling venues. The latter are called here "classical gamblers," because they have also played roulette, blackjack, traditional slot machines and other classical games of chance.
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RESULTS
More than half of the sample reported that they only gambled at slot machines. 257 (58.8%) interviewees can be classified as "slot machine gamblers" and 180 (41.2%) can be classified as "classical gamblers" who also gambled in casinos. Regarding socio-demographic data, there were no differences between these two types of gamblers in this study concerning gender, school education and employment. However, the "slot machine gamblers" were on average younger than the "classical gamblers" (M~ = 29.5 vs. 33.0, t = --3.60, p < .001). The "classical gamblers" held higher positions in their jobs and, consequently, had a higher income than the "slot machine gamblers." The gambling behaviour of the "classical gamblers" was altogether more extensive than the gambling behaviour of the "slot machine gamblers" (see Table 1). Table 1 Variables of Gambling Behavior (N = 437) "Classical" ( , = 180) M
frequency (per week) duration per day (in hours) intensive phase (in months) average stake (in DM) highest loss (in DM) highest win (in DM) total losses (in DM) total debts (in DM)
Slot Machine (~ = 257) s
M
t- Test
s
t
prob.
5.4
1.8
5.1
1.8
1.50
n.s.
4.7
2.1
3.8
1.8
4.79
.001
83.2
70.5
56.9
45.8
4.38
.001
516.4
835.9
185.3
136.3
5.11
.001
4102.4
7443.1
756.3
564.8
5.97
.001
8250.2
17504.9
624.6
687.7
5.79
.001
146832.4
267454.6
50949.6
56483.1
4.64
.001
40889.3
85171.8
18365.1
30178.7
3.37
.001
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While there was no difference in the frequency of gambling--both types of gamblers gambled on average approximately five days a week--the "classical gamblers" gambled more hours per day and their phase of extensive gambling lasted longer. The "classical gamblers' " average stakes, highest losses and also highest winnings as well as their total losses and debts were significantly higher than those of the "slot machine gamblers." These results indicate that more money ran though the "classical gamblers' "hands, but what about the psychological aspects of both groups' gambling behaviour? There were no statistically significant differences between the "slot machine gamblers" and the "classical gamblers" concerning the two gambling motives "Gambling functioning as a substitute or escape (from problems)" and "Gambling as a pleasureable activity." However, the motive "Gambling in order to win money" was on average stronger among the group of the "classical gamblers" (see Table 2). If both groups have similar motives--except the financial o n e - do t h e y a l s 0 have similar feelings while gambling, or to put it another way, do they get similar gratifications from gambling? The answer seems to be yes. There were no statistically significant differences between both groups; subjective experience regarding a happy mood, excitement, self-confidence, dreaminess or concentration while gambling (see Table 3.) While similar gambling motives and a similar subjective experience while gambling may be found among the two groups, the "classical gamblers" had higher scores on the overall scale "Symptoms of Table 2 G a m b l i n g M o t i v e s (N = 437)
scale "Financial win" scale "Pleasurable activity" scale "Function of gambling as substitute or escape"
"Classical ~ (n = 180)
Slot Machine 0 = 257)
M
s
M
s
t
prob.
3.1 2.8
1.9 1.6
2.5 2.8
1.9 1.5
3.25 0.17
.001 n.s.
5.1
2.3
4.7
2.3
1.63
n.s.
t-Test
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Table 3 Subjective Experience While Gambling (N = 437) "Classical ~ (n = 180)
scale "Happy mood while gambling" scale "Excitement while gambling" scale "Selfconfidence while gambling" scale "Dreaminess while gambling" scale "Concentration while gambling"
Slot Machine ( , = 257)
t- Test
M
s
M
s
t
prob.
18.5
30.7
13.9
20.6
1.76
n.s.
9.1
9.3
7.6
8.3
1.73
n.s.
5.2
10.8
3.5
8.3
1.78
n.s.
2.7
7.7
2.0
5.1
1.05
n.s.
4.5
7.0
3.4
4.3
1.82
n.s.
pathological gambling" (see Table 4). Although the "classical gamblers" show more pronounced symptoms of pathological gambling on the overall scale, this is not true for all subscales. While the "classical gamblers" reported more intensive chasing, a larger expansion of gambling (meaning for example higher stakes in order to achieve the craved for excitement), and more "negative withdrawal-like symptoms," there were no statistically significant differences between the "classical gamblers" and the "slot machine gamblers" regarding the subscales "Gambling as central life interest," "Concealment," "Reduction of gambling" (trying to give up gambling altogether) and "Negative withdrawal-like symptoms." The psychosocial consequences of their pathological gambling behaviour were more severe for the "classical gamblers" than for the "slot machine gamblers." The "classical gamblers" reported more frequently loss of job, loss of housing, and separation from their partner because of gambling (see Table 5.) There were no statistically significant differences on the variables measuring the degree of subjectively experienced impairment because
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Table 4 V a r i a b l e s o f P a t h o l o g i c a l G a m b l i n g (N = 437) "Classical" (n = 180)
Slot Machine (,, = 257)
t- Test
M
s
M
s
t
prob.
scale "Symptoms of pathological gambling"
15.5
5.5
14.0
5.5
2.93
.004
subscale "Chasing"
2.1
1.0
1.9
1.1
2.24
.03
subscale "Extension of gambling"
3.7
1.8
3.1
1.8
3.39
.001
subscale "Gambling as central life interest"
7.3
2.7
6.9
2.9
1.86
n.s.
subscale "Concealment"
1.9
0.9
1.9
0.9
0.59
n.s.
subscale "Reduction of gambling"
3.5
1.8
3.1
1.7
1.87
n.s.
subscale "Negative withdrawal-like symptoms"
3.7
3.9
2.7
3.3
2.92
.004
Table 5 P s y c h o s o c i a l Consequences of G a m b l i n g (N = 437) "Classical" Gamblers (n = 257)
CHF
D.F.
loss of job because of gambling
more frequently
8.41
2
.01
loss of housing because of gambling
more frequently
14.37
2
.001
separation from partner because of gambling
more frequently
18.15
2
.001
prob.
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of gambling in various psychosocial areas (e.g. partnership, financial situation, well-being, physical health, job performance, efficiency, social contacts, leisure, zest for life). Regarding financial and legal problems because of gambling, the "classical gamblers" reported more frequently that they sold property and aquired money by illegal means for the purpose of gambling. T h e y were also more frequently convicted for criminal offences because of their gambling. There were no statistically significant differences between the two groups concerning the borrowing of money for gambling purposes or the neglect of financial obligations because of gambling (see Table 6). While the "classical gamblers" meet the diagnostic criteria of pathological gambling to a higher degree than the "slot machine gamblers," there were no statistically significant differences on the variable "Feeling of Dependency on Gambling." Is there a progression from gambling at slot machines to "classical" gambling? 18.6% of the interviewees in this study reported that they changed from one kind of gambling to another for different reasons and in different directions: While 51.3% of this subgroup changed from gambling at slot machines to "classical" gambling because they sought higher stakes and winnings, 33.3% of this subgroup changed from "classical" gambling to slot machine gambling because of high losses or being banned from casinos. Among other reasons some interviewees mentioned curiosity as a reason for extending their gambling experience.
Table 6 Financial and Legal Problems Because of Gambling (N = 437)
borrowing money selling property neglect of financial obligations illegal aquisition of money conviction for criminal offence
"Classical" Gamblers (n = 257)
CHIe
D.F.
more frequently
10.38
2
more frequently more frequently
14.43 14.80
1 I
prob.
n.s. .01 n.s. .001 .001
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DISCUSSION It is hardly surprising that the "classical gamblers' " stakes, losses and winnings as well as debts resulting from gambling are higher than those of the "slot machine gamblers" or that the gambling motive "winning money" is stronger among the "classical gamblers." There is a limit to how much money can be lost or won at slot machines at a time. The "classical gamblers'" gambling behaviour is undoubtedly more extensive from a financial point of view. However, the same can not be said for the emotional intensity of the gambling experience. There were no differences regarding feelings of a happy mood, excitement, self-confidence or dreaminess while gambling. Regarding a cognitive aspect of gambling, both groups were almost equally concentrated while gambling. The crucial point, however, is not whether gambling at slot machines evokes similar feelings as classical games of chance like roulette or blackjack. Having a good time at a slot machine does not necessarily equal pathological gambling. Taking clearly defined diagnostic criteria for pathological gambling into consideration, the results of this study demonstrate that the "classical gamblers" show more pronounced symptoms of pathological gambling, which might be due to the fact that the "slot machine gamblers" were younger. However, almost all interviewees met at least four of the criteria for pathological gambling--they were all members of Gambler's Anonymous groups-and on some of these criteria there were no differences between the "classical gamblers" and the ~slot machine gamblers." Gambling as central life interest, concealment, and trying to reduce gambling do not differentiate between the two types of gamblers. The fact that "classical gamblers" report a higher degree of chasing and the urge to intensify their gambling in order to achieve the desired excitement is not surprising, since stakes are limited and the great "big win" is not possible with slot machines. This may also be an explanation for the longer duration of the extensive gambling phase before declaring themselves as pathological gamblers for the "classical gamblers": "slot machine gamblers" probably find out that gambling may cause unsurmountable problems and give up hope of winning back lost money at an earlier stage. While the psychosocial consequences of their gambling behaviour (loss of job, loss of housing, separation from partner) are less severe for
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the "slot machine gamblers," they seem to be running into the same financial and legal problems as the "classical gamblers." Even though the "classical gamblers" frequently committed more illegal actions, borrowing money for gambling purposes and neglecting financial obligations because of gambling are the first steps on the path to gambling related delinquency (Lesieur, 1979; Meyer & Fabian, 1992). So far we have written as expert witnesses about 40 forensic psychological evaluations about "slot machine gamblers" who had become criminals (Meyer, 1988; Meyer & Fabian, 1988; Meyer, Fabian & Wetzels, 1990). Most of them met the diagnostic criteria of pathological gambling and in the majority of these cases the delinquent behaviour was related to their pathological gambling (Meyer & Fabian, 1994). Obviously classical gambling may cause more severe financial problems which in turn lead to severe psychosocial problems, but from a psychological perspective gambling at slot machines may also lead to pathological gambling. For young people slot machines can be as stimulating and therefore as dangerous as classical gambling. The comparison between the group of the "classical gamblers" and the "slot machine gamblers" has shown that slot machines may be classified as games of chance. The law has so far not been successful in avoiding the danger of pathological gambling at entertainment slot machines. While more financial means are involved in classical gambling which may also lead to more severe psychosocial problems, slot machines nevertheless seem to attract younger people with lesser financial means who may become pathological gamblers when they cannot cope with challenges of jobs or relationships which form part of adult life (Kr6ber, 1992). Of course slot machines themselves are not the cause of pathological g a m b l i n g - t h e causes for pathological gambling lie in psychological and social conditions--but because they qualify as games of chance in a psychological--if not a legal--sense, the slot machine gambler runs a similar risk of acquiring a pathological gambling habit as the classical gambler. REFERENCES American Psychiatric Association (1987). Diagnostic and statistical manual of mental disorders (DSMIII-R) (3rd revised edition). Washington, D.C.: APA. Bfihringer, G. (1992). Spielen--ist das harmlos oder nicht? Der Kassenarzt, 24, 31-32. B/ihringer, G. & Konstanty, R. (1992). Intensive gamblers on German-style slot machines. journal of Gambling Studies, 8, 21-38.
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Griffiths, M. (1993). Fruit machine gambling: The importance of structural characteristics. Journal of Gambling Studies, 9, 101-120. Herbst, K. (1993). Verlaufsanalyse bei Spielern an Geldspielautomaten in Spielhallen. Praxis der Klinischen Verhaltensmedizin und Rehabilitation, 6, 114-125. Janke, W. & Debus, G. (1978). Die Eigenschaftswgrterliste (EWL). G6ttingen: Hogrefe. Kellermann, B. & Sostmann, M. (1992). Pathologisches Aut.omaten-Glficksspielen aus der Sicht einer psychiatrischen Suchttherapiestation. Hamburger Arzteblatt, 46, 169-176. Klepsch, R., Hand, I., Wlazlo, Z., Fischer, M., Friedrich, B. & Bodek, D. (1989). Langzeiteffekte multimodaler Verhaltenstherapie bei krankhaftem Glficksspielen, III: Zweite Katamnese der Hamburger Projektstudie. Suchtgefahren, 35, 35-49. Kr6ber, H.-L. (1992). Roulette gamblers and gamblers at electronic game machines: Where are the differences? Journal of Gambling Studies, 8, 79-92. Lesieur, H. (1979). The compulsive gambler's spiral of options and involvement. Psychiatry, 42, 79-87. Meyer, G. (1988). Schuldf'~ihigkeit bei Abhfingigkeit vom Gliicksspiel. Monatsschrift fiir Kriminologie und Strafrechtsreform, 71, 213-227. Meyer, G. (1989). GliicksspMer in Selbsthilfegruppen. Hamburg: Neuland. Meyer, G. (1992). The gambling market in the Federal Republic of Germany and the helpseeking of pathological gamblers. Journal of Gambling Studies, 8, 11-20. Meyer, G. & Fabian, T. (1988). AbhS.ngigkeit vom Glficksspiel und Beschaffungskriminalit~t. In C. Wahl (Ed.), Spielsucht (pp. 103-132). Hamburg: Neuland. Meyer, G. & Fabian, T. (1992). Delinquency among pathological gamblers: A causal approach. Journal of Gambling Studies, 8, 61-77. Meyer, G. & Fabian, T. (1994, May-June). Pathological gambling and delinquency: An analysis of forensic evaluations. Paper presented at the 9th International Conference on Gambling and Risk Taking, Las Vegas. Meyer, G., Fabian, T. & Wetzels, P. (1990). Kriminalpsychologische Aspekte und forensischpsychologische Wertung des pathologischen G1/icksspiels. Strafverteidiger, 10, 464-469. Mokken, R.J. (1971). A theory and procedure of scale analysis. The Hague: Mouton. Rohwedder, D. (1987). Das AutomatenspM. Moderne Freizeit-Gestaltung. Bonn: Mittelstandsverlag. Schwarz, J. & Lindner, A. (1992). Inpatient treatment of male pathological gamblers in Germany. Journal of Gambling Studies, 8, 93-109. Strobl, M. (1991). Excerptfrom the Ebis statistics 1988-1990 on gambling. Unpublished Manuscript. Workshop "Pathologisches Spielverhalten', Deutsche HauptsteUe gegen Suchtgefahren.
Department of Social Work Hochschule fiir Technik, Wirtschaft und Kultur Leipzig (FH), Germany
German-style slot machines and related legal issues are described. On the basis of a survey on 437 members of self-help groups (Gamblers Anonymous) in Germany, slot machine gamblers were compared with casino gamblers on such variables as sociodemographic data, gambling behaviour, financial expenditure, emotional experience while gambling, symptoms of pathological gambling, psychosocial consequences and gambling related delinquency. The casino gamblers' gambling behaviour is financially more extensive. There were similarities regarding the emotional intensity of the gambling experience. However the casino gamblers show more pronounced symptoms of pathological gambling and the psychosocial consequences of their gambling behaviour are more severe. In spite of these differences, the data show that for young people slot machines can be as stimulating and therefore as dangerous as casino gambling. The young slot machine gambler runs a similar risk of acquiring a pathological gambling habit as the casino gambler.
INTRODUCTION I n G e r m a n y s l o t - m a c h i n e s w i t h m o n e y - w i n n i n g c h a n c e s for t h e g a m b l e r ( G e r m a n - s t y l e slot-machines) m a y be installed in a m u s e m e n t
I would like to thank Dr. Gerhard Meyer for his support and his commentson the first draft of this article which is based on data from a research project led by him. Address correspondenceand reprint requests to Prof. Dr. Thomas Fabian, Hochschule ffir Technik, Wirtschaft und Kultur Leipzig (FH), Fachbereich Socialwesen, PF 66, D-04251 Leipzig, Federal Republic of Germany.
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arcades and pubs. These so-called "entertainment slot-machines with chances of winnings" are not defined as games of chance by law. G a m e s of chance may be organized only under state supervision and control, the classical slot-machines are therefore allowed only in state-run casinos.
Legal Issues There are a number of government regulations concerning "entertainment slot-machines with chances of winnings," which are m e a n t to keep winnings and losses at a low rate and thereby exclude the possibility of substantial sums being won or lost. The purpose of these regulations is to distinguish between slot-machines and actual games of chance and allow their commercial operation. The provisions of the Gambling Decree for slot machines are as follows: --maximum --maximum --minimum --minimum
stake per game: 0.30 D M ($1 U.S. -- 1.60 D M ) , winnings per game: 3.00 D M , running time per game: 15 seconds, rate of money paid out: 53.4%.
The decree permits the installation of no more than ten slotmachines in amusement arcades (on an area of at least 150 m 2) and of no more than two slot-machines in pubs. Persons under the age o f 18 are not allowed admittance to amusement arcades. These legal regulations are meant to protect the gambler from an "excessive exploitation of the gambling urge" (5 33 ft. Trading Regulations).
The New Generation of German-style Slot Machines However, by combining gambling sequences the slot machine industry succeeded in introducing new gambling systems (special games and games involving extra risks) which circumvent the intentions of the law. In the special gambling series (with up to 200 special games) about every second game yields the m a x i m u m winning of 3.00 D M . Winnings can therefore add up to as much as 240.00 D M , a sum which for gamblers with low income represents a substantial value. As a rule the series are set off on the three discs of the slot-machine after a
THOMAS FABIAN
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combination of certain symbols has appeared. The special-risk game allows winnings of the basic game to be doubled, step by step, by pressing a button. In this way up to 50 special games can be played. The gamblers can therefore stake more (i.e. run higher risks) than laid down by the law. By pressing "stop", "start" and "risk" buttons gamblers are under the illusion that they take an active part in the game, although in reality they cannot influence the result, because it is already determined by the slot machine's electronic programme. With an average loss of 33.60 D M per hour (max. 72.00 DM) at one machine and the possibility o f gambling at several machines simultaneously, the losses can add up to sums which put the gamblers' property at risk. The entertainment slot machines with money-winning chances therefore fulfil the criteria of a game of chance, i.e. they involve the risk of substantial financial losses and the possibility of substantial winnings.
Political Debate and "Voluntary Self-restricting Agreements ~ by the Slotmachine Industry After the expansion of amusement arcades in the eighties (in 1991 there were approximately 6,500 amusement arcades in Germany, not counting the former German Democratic Republic), obvious "maldevelopments" and the public debate about "pathological gambling," the German Bundestag (lower house of Parliament) called for measures which would lessen the incentive for gamblers on slot machines (1991: 175,000). Such measures were taken by the slot machine industry in the form of "voluntary self-restricting agreements" and have been in force since the 4th of November 1990 (BT Mitteilung 11/6224) (see Meyer, 1992): --limitation of special games which allow cumulative winnings to 150 games, --limitation of the coin store to a m a x i m u m of 50 DM, --limitation of the risk series to 50 special games, -- introduction of a compulsory break of three minutes after one hour's uninterrupted gambling, --warning notice on the front panel of the slot machines (Figure
1),
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STUDIES
Figure 1 Warning Notice by the Slot-Machine I n d u s t r y
":Jugendschutz- ist keine L6sung Gesetz w 8" bei pers6nlichen Problemen
"N' lnfo: ortsta,',0130 3727
The two warnings of the sign read: "Not under the age of 18 according to the law." and "Excessive playing is no solution to personal problems."
--provision of information material on the dangers of frequent gambling, --prevention of simultaneous gambling on more than two machines, --restriction of advertisement for slot machines. However, the preventive effect of these measures is probably negligible, since gambling on slot machines retains the characteristics of games of chance, i.e. substantial winnings and losses. Besides, many operators do not keep to the agreements (BT Mitteilung 1213232). In March 1993 the Bundesrat (upper house of Parliament) approved a motion of the Ministery of Trade and Commerce for an increase of the stake and maximum winnings to 0.40 DM and 4.00 DM, respectively, which amounts to an increased incentive for gambling (Bundesrat Mitteilung 126/93). At the same time the Bundesrat
THOMAS FABIAN
253
asked the Federal Government for an amendment to the Gambling Decree which would prohibit, or at least greatly restrict, the possibility of winnings by special and extra risk games on slot machines. However, while the increase of stakes and winnings came into force in M a y 1993, the realization of the second resolution, which would truly be of a preventive nature, is still "up in the air."
German-style Slot Machines and Pathological Gambling The development of slot machines into games of chance and the consequent boom of amusement arcades have attracted about 10% of the population (approximately 4.6 million) as active gamblers, i.e. they gambled on slot machines during the past three months (Bfihringer, 1992). T h e y are especially frequented by young people (18-30 years of age) with low incomes (Rohwedder, 1987; Bfihringer & Konstanty, 1992). For this group of people, gambling on slot machines means putting their property at stake. For them, slot machines have the typical attractions of games of chance, like roulette has for financially better-off citizens. From a psychological point of view, there exists a pronounced addiction potential in gambling on slot machines because of the following structural characteristics (see also Griffiths, 1993): --rapid gambling sequence (high frequency of events) and short pay out intervals - wide variety of stakes a n d chances of winning (referring to the extra risk and special games system) - t h e attractive relation between the probability of winning on one hand and the amount of winnings (for persons with low incomes) as well as the number of small winnings on the other hand --the active involvement of the gambler in the course of the game (by pressing "stop", "start" and "risk" buttons) --the low stakes (0.30 or 0.40 D M per game) One consequence of this is that slot machine gamblers may develop pathological gambling behaviour. So far there are no reliable data on the prevalence of such behaviour. Existing estimates of the n u m b e r of gamblers concerned differ significantly. While pathological
254
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gamblers in self-help groups estimate the number of pathological gamblers as 1,000,000, B/ihringer (1992) (see also B/ihringer & Konstanty, 1992) estimated a lower figure of 30,000 with about 8,000 "frequent gamblers on slot machines under subjective stress" among them. However, a study of slot machine gamblers in amusement arcades showed that at times 15 % of all gamblers were under strong emotional stress (Herbst, 1993). Doubts about the reliability of these estimates arise when the demand by slot machine gamblers for therapy is taken into account. In 1988, for instance, approximately 4,900 gamblers, who only gambled on slot machines, went to an out-patient institution which provided advice and treatment (Strobl, 1991); this would mean that during that year more than 61% of the gamblers had out-patient therapy. In comparison: in 1991 approximately 79.,000 of the estimated 2.4 million alcoholics were treated in out-patient institutions, i.e. 3.3% of all concerned asked for therapy. In general, it takes several years before problem gamblers go to an advice centre. At first, it is always possible to find solutions for financial problems, therefore seeking help is put off. Psychosocial harm as a consequence of excessive gambling becomes evident only relatively late. In addition, pathological gamblers are less willing to admit that they need treatment than alcoholics or heroin addicts. This is because pathological gambling is perceived as having no physiological causes and involving hardly any physical harm. On the basis of the demand for therapy in out-patient institutions and through comparison with addictions to drugs and alcohol, the number of gamblers in Germany who are in need of advice and treatment is estimated at approximately 200,000. Both in out-patient and in-patient treatment centres for pathological gamblers as well as in self-help groups of "Gamblers Anonymous," gamblers who only gamble on slot machines represent the biggest group (Klepsch, Hand, Wlazlo, Fischer, Friedrich & Bodek, 1989; Meyer, 1989; Kellermann & Soest, 1992; Schwarz & Lindner, 1992). Their proportion varies between 59% and 83 %. The following question therefore arises. If slot machines may be classified as games of chance in the same way as the classical ones like roulette or blackjack, do they subsequently involve a similar risk to develop a pathological gambling behaviour? This question was examined in the following study.
THOMAS FABIAN
255
METHOD
Sample 437 gamblers from 54 self-help groups were interviewed. The mean age of the mainly male (95%) interviewees was 31 years. In comparison with the age structure of the overall population the age group 20 to under 40 is overrepresented in this sample. The male interviewees had a better education, with respect to profession and monthly net income. There were no substantial divergences from the overall population. 91.6 % of the interviewees met at least four of the nine diagnostic criteria of the DSM-III-R (APA, 1987) for pathological gambling.
Procedure
All 54 existing self-help groups for gamblers in the Federal Republic of Germany were contacted in 1987 and the group members were interviewed with standardized instruments. These consisted of a comprehensive questionnaire about a wide range of different aspects of gambling including the diagnostic criteria of the DSM-III-R which was developed for the purpose of this investigation, a list of adjectives for self-description of the emgtional state while gambling (following Janke & Debus, 1978) and questions concerning socio-demographic data. The instruments were tested with a probabilistic scaling procedure (Mokken, 1971). A detailed description of all instruments has been published in a report of the research project (Meyer, 1989). Group comparisons (t-test, Chi squared-test) were made regarding gambling behaviour, symptoms of pathological gambling and psychosocial consequences between those interviewees who reported to have gambled only at slot machines and those who reported to also have gambled in casinos run by the state or illegal gambling venues. The latter are called here "classical gamblers," because they have also played roulette, blackjack, traditional slot machines and other classical games of chance.
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RESULTS
More than half of the sample reported that they only gambled at slot machines. 257 (58.8%) interviewees can be classified as "slot machine gamblers" and 180 (41.2%) can be classified as "classical gamblers" who also gambled in casinos. Regarding socio-demographic data, there were no differences between these two types of gamblers in this study concerning gender, school education and employment. However, the "slot machine gamblers" were on average younger than the "classical gamblers" (M~ = 29.5 vs. 33.0, t = --3.60, p < .001). The "classical gamblers" held higher positions in their jobs and, consequently, had a higher income than the "slot machine gamblers." The gambling behaviour of the "classical gamblers" was altogether more extensive than the gambling behaviour of the "slot machine gamblers" (see Table 1). Table 1 Variables of Gambling Behavior (N = 437) "Classical" ( , = 180) M
frequency (per week) duration per day (in hours) intensive phase (in months) average stake (in DM) highest loss (in DM) highest win (in DM) total losses (in DM) total debts (in DM)
Slot Machine (~ = 257) s
M
t- Test
s
t
prob.
5.4
1.8
5.1
1.8
1.50
n.s.
4.7
2.1
3.8
1.8
4.79
.001
83.2
70.5
56.9
45.8
4.38
.001
516.4
835.9
185.3
136.3
5.11
.001
4102.4
7443.1
756.3
564.8
5.97
.001
8250.2
17504.9
624.6
687.7
5.79
.001
146832.4
267454.6
50949.6
56483.1
4.64
.001
40889.3
85171.8
18365.1
30178.7
3.37
.001
THOMAS FABIAN
257
While there was no difference in the frequency of gambling--both types of gamblers gambled on average approximately five days a week--the "classical gamblers" gambled more hours per day and their phase of extensive gambling lasted longer. The "classical gamblers' " average stakes, highest losses and also highest winnings as well as their total losses and debts were significantly higher than those of the "slot machine gamblers." These results indicate that more money ran though the "classical gamblers' "hands, but what about the psychological aspects of both groups' gambling behaviour? There were no statistically significant differences between the "slot machine gamblers" and the "classical gamblers" concerning the two gambling motives "Gambling functioning as a substitute or escape (from problems)" and "Gambling as a pleasureable activity." However, the motive "Gambling in order to win money" was on average stronger among the group of the "classical gamblers" (see Table 2). If both groups have similar motives--except the financial o n e - do t h e y a l s 0 have similar feelings while gambling, or to put it another way, do they get similar gratifications from gambling? The answer seems to be yes. There were no statistically significant differences between both groups; subjective experience regarding a happy mood, excitement, self-confidence, dreaminess or concentration while gambling (see Table 3.) While similar gambling motives and a similar subjective experience while gambling may be found among the two groups, the "classical gamblers" had higher scores on the overall scale "Symptoms of Table 2 G a m b l i n g M o t i v e s (N = 437)
scale "Financial win" scale "Pleasurable activity" scale "Function of gambling as substitute or escape"
"Classical ~ (n = 180)
Slot Machine 0 = 257)
M
s
M
s
t
prob.
3.1 2.8
1.9 1.6
2.5 2.8
1.9 1.5
3.25 0.17
.001 n.s.
5.1
2.3
4.7
2.3
1.63
n.s.
t-Test
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JOURNAL OF GAMBLING STUDIES
Table 3 Subjective Experience While Gambling (N = 437) "Classical ~ (n = 180)
scale "Happy mood while gambling" scale "Excitement while gambling" scale "Selfconfidence while gambling" scale "Dreaminess while gambling" scale "Concentration while gambling"
Slot Machine ( , = 257)
t- Test
M
s
M
s
t
prob.
18.5
30.7
13.9
20.6
1.76
n.s.
9.1
9.3
7.6
8.3
1.73
n.s.
5.2
10.8
3.5
8.3
1.78
n.s.
2.7
7.7
2.0
5.1
1.05
n.s.
4.5
7.0
3.4
4.3
1.82
n.s.
pathological gambling" (see Table 4). Although the "classical gamblers" show more pronounced symptoms of pathological gambling on the overall scale, this is not true for all subscales. While the "classical gamblers" reported more intensive chasing, a larger expansion of gambling (meaning for example higher stakes in order to achieve the craved for excitement), and more "negative withdrawal-like symptoms," there were no statistically significant differences between the "classical gamblers" and the "slot machine gamblers" regarding the subscales "Gambling as central life interest," "Concealment," "Reduction of gambling" (trying to give up gambling altogether) and "Negative withdrawal-like symptoms." The psychosocial consequences of their pathological gambling behaviour were more severe for the "classical gamblers" than for the "slot machine gamblers." The "classical gamblers" reported more frequently loss of job, loss of housing, and separation from their partner because of gambling (see Table 5.) There were no statistically significant differences on the variables measuring the degree of subjectively experienced impairment because
THOMAS FABIAN
259
Table 4 V a r i a b l e s o f P a t h o l o g i c a l G a m b l i n g (N = 437) "Classical" (n = 180)
Slot Machine (,, = 257)
t- Test
M
s
M
s
t
prob.
scale "Symptoms of pathological gambling"
15.5
5.5
14.0
5.5
2.93
.004
subscale "Chasing"
2.1
1.0
1.9
1.1
2.24
.03
subscale "Extension of gambling"
3.7
1.8
3.1
1.8
3.39
.001
subscale "Gambling as central life interest"
7.3
2.7
6.9
2.9
1.86
n.s.
subscale "Concealment"
1.9
0.9
1.9
0.9
0.59
n.s.
subscale "Reduction of gambling"
3.5
1.8
3.1
1.7
1.87
n.s.
subscale "Negative withdrawal-like symptoms"
3.7
3.9
2.7
3.3
2.92
.004
Table 5 P s y c h o s o c i a l Consequences of G a m b l i n g (N = 437) "Classical" Gamblers (n = 257)
CHF
D.F.
loss of job because of gambling
more frequently
8.41
2
.01
loss of housing because of gambling
more frequently
14.37
2
.001
separation from partner because of gambling
more frequently
18.15
2
.001
prob.
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JOURNAL OF GAMBLING STUDIES
of gambling in various psychosocial areas (e.g. partnership, financial situation, well-being, physical health, job performance, efficiency, social contacts, leisure, zest for life). Regarding financial and legal problems because of gambling, the "classical gamblers" reported more frequently that they sold property and aquired money by illegal means for the purpose of gambling. T h e y were also more frequently convicted for criminal offences because of their gambling. There were no statistically significant differences between the two groups concerning the borrowing of money for gambling purposes or the neglect of financial obligations because of gambling (see Table 6). While the "classical gamblers" meet the diagnostic criteria of pathological gambling to a higher degree than the "slot machine gamblers," there were no statistically significant differences on the variable "Feeling of Dependency on Gambling." Is there a progression from gambling at slot machines to "classical" gambling? 18.6% of the interviewees in this study reported that they changed from one kind of gambling to another for different reasons and in different directions: While 51.3% of this subgroup changed from gambling at slot machines to "classical" gambling because they sought higher stakes and winnings, 33.3% of this subgroup changed from "classical" gambling to slot machine gambling because of high losses or being banned from casinos. Among other reasons some interviewees mentioned curiosity as a reason for extending their gambling experience.
Table 6 Financial and Legal Problems Because of Gambling (N = 437)
borrowing money selling property neglect of financial obligations illegal aquisition of money conviction for criminal offence
"Classical" Gamblers (n = 257)
CHIe
D.F.
more frequently
10.38
2
more frequently more frequently
14.43 14.80
1 I
prob.
n.s. .01 n.s. .001 .001
THOMAS FABIAN
261
DISCUSSION It is hardly surprising that the "classical gamblers' " stakes, losses and winnings as well as debts resulting from gambling are higher than those of the "slot machine gamblers" or that the gambling motive "winning money" is stronger among the "classical gamblers." There is a limit to how much money can be lost or won at slot machines at a time. The "classical gamblers'" gambling behaviour is undoubtedly more extensive from a financial point of view. However, the same can not be said for the emotional intensity of the gambling experience. There were no differences regarding feelings of a happy mood, excitement, self-confidence or dreaminess while gambling. Regarding a cognitive aspect of gambling, both groups were almost equally concentrated while gambling. The crucial point, however, is not whether gambling at slot machines evokes similar feelings as classical games of chance like roulette or blackjack. Having a good time at a slot machine does not necessarily equal pathological gambling. Taking clearly defined diagnostic criteria for pathological gambling into consideration, the results of this study demonstrate that the "classical gamblers" show more pronounced symptoms of pathological gambling, which might be due to the fact that the "slot machine gamblers" were younger. However, almost all interviewees met at least four of the criteria for pathological gambling--they were all members of Gambler's Anonymous groups-and on some of these criteria there were no differences between the "classical gamblers" and the ~slot machine gamblers." Gambling as central life interest, concealment, and trying to reduce gambling do not differentiate between the two types of gamblers. The fact that "classical gamblers" report a higher degree of chasing and the urge to intensify their gambling in order to achieve the desired excitement is not surprising, since stakes are limited and the great "big win" is not possible with slot machines. This may also be an explanation for the longer duration of the extensive gambling phase before declaring themselves as pathological gamblers for the "classical gamblers": "slot machine gamblers" probably find out that gambling may cause unsurmountable problems and give up hope of winning back lost money at an earlier stage. While the psychosocial consequences of their gambling behaviour (loss of job, loss of housing, separation from partner) are less severe for
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JOURNAL OF GAMBLING STUDIES
the "slot machine gamblers," they seem to be running into the same financial and legal problems as the "classical gamblers." Even though the "classical gamblers" frequently committed more illegal actions, borrowing money for gambling purposes and neglecting financial obligations because of gambling are the first steps on the path to gambling related delinquency (Lesieur, 1979; Meyer & Fabian, 1992). So far we have written as expert witnesses about 40 forensic psychological evaluations about "slot machine gamblers" who had become criminals (Meyer, 1988; Meyer & Fabian, 1988; Meyer, Fabian & Wetzels, 1990). Most of them met the diagnostic criteria of pathological gambling and in the majority of these cases the delinquent behaviour was related to their pathological gambling (Meyer & Fabian, 1994). Obviously classical gambling may cause more severe financial problems which in turn lead to severe psychosocial problems, but from a psychological perspective gambling at slot machines may also lead to pathological gambling. For young people slot machines can be as stimulating and therefore as dangerous as classical gambling. The comparison between the group of the "classical gamblers" and the "slot machine gamblers" has shown that slot machines may be classified as games of chance. The law has so far not been successful in avoiding the danger of pathological gambling at entertainment slot machines. While more financial means are involved in classical gambling which may also lead to more severe psychosocial problems, slot machines nevertheless seem to attract younger people with lesser financial means who may become pathological gamblers when they cannot cope with challenges of jobs or relationships which form part of adult life (Kr6ber, 1992). Of course slot machines themselves are not the cause of pathological g a m b l i n g - t h e causes for pathological gambling lie in psychological and social conditions--but because they qualify as games of chance in a psychological--if not a legal--sense, the slot machine gambler runs a similar risk of acquiring a pathological gambling habit as the classical gambler. REFERENCES American Psychiatric Association (1987). Diagnostic and statistical manual of mental disorders (DSMIII-R) (3rd revised edition). Washington, D.C.: APA. Bfihringer, G. (1992). Spielen--ist das harmlos oder nicht? Der Kassenarzt, 24, 31-32. B/ihringer, G. & Konstanty, R. (1992). Intensive gamblers on German-style slot machines. journal of Gambling Studies, 8, 21-38.
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Griffiths, M. (1993). Fruit machine gambling: The importance of structural characteristics. Journal of Gambling Studies, 9, 101-120. Herbst, K. (1993). Verlaufsanalyse bei Spielern an Geldspielautomaten in Spielhallen. Praxis der Klinischen Verhaltensmedizin und Rehabilitation, 6, 114-125. Janke, W. & Debus, G. (1978). Die Eigenschaftswgrterliste (EWL). G6ttingen: Hogrefe. Kellermann, B. & Sostmann, M. (1992). Pathologisches Aut.omaten-Glficksspielen aus der Sicht einer psychiatrischen Suchttherapiestation. Hamburger Arzteblatt, 46, 169-176. Klepsch, R., Hand, I., Wlazlo, Z., Fischer, M., Friedrich, B. & Bodek, D. (1989). Langzeiteffekte multimodaler Verhaltenstherapie bei krankhaftem Glficksspielen, III: Zweite Katamnese der Hamburger Projektstudie. Suchtgefahren, 35, 35-49. Kr6ber, H.-L. (1992). Roulette gamblers and gamblers at electronic game machines: Where are the differences? Journal of Gambling Studies, 8, 79-92. Lesieur, H. (1979). The compulsive gambler's spiral of options and involvement. Psychiatry, 42, 79-87. Meyer, G. (1988). Schuldf'~ihigkeit bei Abhfingigkeit vom Gliicksspiel. Monatsschrift fiir Kriminologie und Strafrechtsreform, 71, 213-227. Meyer, G. (1989). GliicksspMer in Selbsthilfegruppen. Hamburg: Neuland. Meyer, G. (1992). The gambling market in the Federal Republic of Germany and the helpseeking of pathological gamblers. Journal of Gambling Studies, 8, 11-20. Meyer, G. & Fabian, T. (1988). AbhS.ngigkeit vom Glficksspiel und Beschaffungskriminalit~t. In C. Wahl (Ed.), Spielsucht (pp. 103-132). Hamburg: Neuland. Meyer, G. & Fabian, T. (1992). Delinquency among pathological gamblers: A causal approach. Journal of Gambling Studies, 8, 61-77. Meyer, G. & Fabian, T. (1994, May-June). Pathological gambling and delinquency: An analysis of forensic evaluations. Paper presented at the 9th International Conference on Gambling and Risk Taking, Las Vegas. Meyer, G., Fabian, T. & Wetzels, P. (1990). Kriminalpsychologische Aspekte und forensischpsychologische Wertung des pathologischen G1/icksspiels. Strafverteidiger, 10, 464-469. Mokken, R.J. (1971). A theory and procedure of scale analysis. The Hague: Mouton. Rohwedder, D. (1987). Das AutomatenspM. Moderne Freizeit-Gestaltung. Bonn: Mittelstandsverlag. Schwarz, J. & Lindner, A. (1992). Inpatient treatment of male pathological gamblers in Germany. Journal of Gambling Studies, 8, 93-109. Strobl, M. (1991). Excerptfrom the Ebis statistics 1988-1990 on gambling. Unpublished Manuscript. Workshop "Pathologisches Spielverhalten', Deutsche HauptsteUe gegen Suchtgefahren.
