risk & protective factor framework: application to problem gambling
DESCRIPTION
Keynote presentation, 6/26/13. Midwest Conference on Problem Gambling & Substance Abuse. Presenter: Julie Hynes, MA, CPSTRANSCRIPT
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Risk Factors
& Protective
Julie Hynes, MA, CPS
Midwest Conference on Problem Gambling & Substance Abuse
June 26, 2013 | Kansas City, MO
in Prevention and where problem gambling fits in
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promote the wellbeing
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beforechange the factors
that contribute to it.
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PROBLEM BEHAVIORS
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Promotion & Prevention And prevention is finally REALLY on
the national agenda (!)
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Kernels
Resiliency T
heory
ADVERSE CHILDHOOD
EXPERIENCES (ACE)
40 DEVELOPMENTAL
ASSETS
SOCIAL DEVELOPMENT
STRATEGY
PROMOTIVE FACTORS
Risk & Protective Factor Theory
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Problem behaviors share common risk
factors
Exposure to risk factors a
young person’s risk
exponentially
Protective factors buffer exposure
to risk & build on strengths
The Risk & Protective Factor Theory:
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Risk-Focused Prevention • Decades of research: Hawkins, Catalano
& other researchers (Biglan, Embry, etc.)
• PREVENT problem behavior from
happening:
– Identify factors that increase risk of
problem and then find ways to reduce those
risks
– Enhance protective/resiliency factors
• Four Domains:
– Community -- Family
– School -- Individual/Peer
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Risk Factor A characteristic at the
biological, psychological,
family, community, or
cultural level that
precedes and is associated
with a higher likelihood of
problem outcomes
Source: CAPT http://captus.samhsa.gov
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Risk Factor
(In other words, a factor
that increases risk.)
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My Analogy
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“Recognized” Problem Behaviors
• Substance abuse
• Violence
• Delinquency
• Teenage pregnancy
• School dropout
• Depression
Problem gambling?? (not yet)
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Risk Factors for Adolescent
Problem Behavior
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Risk Factors for Adolescent
Problem Behavior
(There will be a test on your vision, &
memorization of this, later.
Otherwise it’s online.)
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Protective Factors:
Individual Characteristics:
– Gender (go, girls!)
– Resilient Temperament
– Positive Social Orientation
– Intelligence (!?)
Protective Processes:
– Opportunities for involvement
– Social and cognitive skills
– Recognition
Dickson, Derevensky & Gupta, 2002
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Image source: Greater Old Town Communities that Care, Maine
when
We give
Opportunity,
Skills and
Recognition.
Combined w/
some of those
Individual Characteristics.
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Quick
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Risk or Protective? Individual, family, community?
Young people who feel school is
important.
Young people who live in
communities with norms tolerant
of use.
Young people who believe drug use
is dangerous.
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Young people who have friends
who use alcohol or marijuana.
Young people who have an
opportunity to contribute to their
schools.
Young people who begin ______ at
an early age.
Risk or Protective? Individual, family, community ?
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but where does
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Back at the office, Click to go
http://www.problemgamblingprevention.org/resources/prevention-
resource-guide03.pdf
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Back at the office, Click to go
http://youthgambling.mcgill.ca/en/PDF/Publications/2008/Dickson%20article.pdf
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School:
– Anti-Social behavior
Individual/Peer:
– Peer Involvement
– Favorable Attitudes
– Early Initiation
– Constitutional
Source: Dickson, Derevensky & Gupta, 2002; Marotta & Hynes, 2003
“Probable” SHARED Risk Factors for
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Community:
– Availability
– Community Laws & Norms
Family:
– Family History
– Family Conflict (competition)
– Parental Attitudes/Involvement
“Probable” SHARED Risk Factors for
Source: Dickson, Derevensky & Gupta, 2002; Marotta & Hynes, 2003
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• Single-parent
household
• Gambling on
cards/sports
• Being male, older teen
• Lower household
income
• Competitive
• Having lost more than
$50 in a single month
• Started gambling
before 8th grade (early
initiation)
• Parents who gamble--
youth twice as likely
to be at-risk gamblers
& four times as likely
to be problem gamblers
Source: Volberg, et al (2008.
Specifics: Risk Factors for youth
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“A” Unique Set of Risks
Gambling
is
decades
behind
ATOD!
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A
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A
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A
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A
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“The earlier people begin
gambling, the more likely
they are to experience
problems from gambling.”
- National Academy of Sciences
A
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A•Amygdala active
•Fight or flight,
emotion
•Decision-making
altered
•More vulnerable to
risk-taking &
impulsive behaviors
Source: Ramoski, S., Nystrom, R. (2007).
“The adolescent brain is
especially sensitive to the
effects of dopamine.
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2012 Oregon Student Wellness Survey, Lane County (“ESD”) and Oregon; available at http://oregon.pridesurveys.com/esds.php?year=2011
AWARENESS (low)
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AWARENESS
Oregon parent/youth focus groups :
Source: Oregon Health Authority
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ATTITUDES
Most parents &
communities believe: Youth gambling is harmless
Youth who gamble are
unlikely to have
problems in school
Youth gambling is not
associated with
alcohol or drug use
…and those beliefs are
part of the problem!
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GETTING REAL By the
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2012 OREGON
STUDENT WELLNESS SURVEY (SWS)
2012 Gambling, Substance Use and Mental Health
among Oregon Youth
0%
10%
20%
30%
40%
50%
Gambling Alcohol Binge
Alcohol
Marijuana Cigarettes Depression Psych
distress
Per
cent
ag
e
6th 8th
11th
Source: Oregon Health Authority, 2012. All SWS data is available online at http://www.oregon.gov/oha/amh/pages/student-wellness/index.aspx n=55,611 students (18,885 6th grade; 21,368 8th grade; 15,358 11th grade)
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Used alcohol in the past month
3.1%
14.6%
29.5%
14.9%
30.9%
46.9%
Grade 6 Grade 8 Grade 11
Did not gamble Gambled
Source: Oregon Health Authority, 2012. Regression analysis conducted by state epidemiologist Rusha Grinstead, MPH. All SWS data is available online at http://www.oregon.gov/oha/amh/pages/student-wellness/index.aspx
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Binge drank in the past month
0.5%
5.6%
16.4%
4.3%
12.7%
28.7%
Grade 6 Grade 8 Grade 11
Did not gamble Gambled
Source: Oregon Health Authority (ibid)
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Smoked cigarettes in the past month
1.1%
6.2%
12.5%
5.1%
10.8%
18.7%
Grade 6 Grade 8 Grade 11
Did not gamble Gambled
Source: Oregon Health Authority (ibid)
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Used marijuana in the past month
0.7%
8.3%
19.3%
4.3%
15.8%
28.4%
Grade 6 Grade 8 Grade 11
Did not gamble Gambled
Source: Oregon Health Authority (ibid)
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5.7%
12.8%
22.5%
15.4%
23.0%
35.4%
Grade 6 Grade 8 Grade 11
Did not gamble Gambled
Skipped school one or more days in the past month
Source: Oregon Health Authority (ibid)
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7.2%
5.0%
11.3%
9.0%
Grade 8 Grade 11
Did not gamble Gambled
Attempted suicide in the past year
Source: Oregon Health Authority (ibid)
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Attempted suicide in the past year
10.1% 8.0%
21.0% 18.6%
Grade 8 Grade 11
Did not bet/gamble more than wanted to
Bet/gambled more than wanted to
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Delinquency (physical fight in last month)
41.80%
22.40%
Physical fight
Gambled Did not gamble
Source: Oregon Health Authority (ibid)
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CONCLUSION?
Teens who gamble are
smoked up, toked up,
drunk emo delinquents.
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CONCLUSION?
Teens who gamble are
smoked up, toked up,
drunk emo delinquents.
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delinquency
sexual
behavior
depression
substance
use
gambling
Problem
Behaviors
Conclusion: Problem Gambling is
One Component of Problem Behaviors
Adapted from: Jeffrey Derevensky
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Protective Factors & Gambling
60.60%
29%
65.90%
21.80%
Strong Positive Youth development Depression
Gambled Did not gamble
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43.80%
32.90%
53.70%
23.20%
Likes school absenteeism
Gambled Did not gamble
Protective Factors & Gambling
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Protective Factors & Gambling
Lussier et al (2007):
Social bonding &
personal competence
related to lower
gambling severity.
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SO NOW WHAT? PREVENTION in action
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• Tobacco, alcohol, and
other drug use and abuse
• Delinquency and crime
• Premature or unsafe sex
• Depression and suicidality
• School failure, dropout
Scientific consensus is that that we can prevent these problems
Source: Project WEAVE, 2011
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By creating nurturing environments using EVIDENCE-BASED
PREVENTION PRACTICES
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Pre-
conceptio
n
Prenatal/
Infancy
Early
Childhood Childhood
Early
Adolescence Adolescence
Family
• Prenatal care
• Home visiting
• Evidence-based parenting
programs
• Evidence-based kernels
Schools
• High-quality preschool and daycare
• Classroom-based prevention curricula
• Evidence-based kernels
• Afterschool programs
Community
• Community organizing to improve neighborhood environments
• Support for evidence-based strategies
• Support for out-of-school activities
• Evidence-based kernels
Policy
• Community members have ensured access to services to meet
basic needs
• Promotion and support of healthy lifestyles
• Policy to promote and support evidence-based strategies
Prevention strategies by developmental phase and domain
Source: Project WEAVE, 2011
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The right support to the right people
Ideally, we would have varying levels
of support to meet the needs of
diverse youth and their families. Size of population affected
More intensive for at-
risk youth and families
~15%
Most intensive
interventions for the
youth and families at
highest risk
~10%
Universal supports for
all youth
and families
~75%
Source: Project WEAVE, 2011
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Evidence-based prevention is
a good investment
$61 $120 $880
$1,200
$15
$30,828
$79,935 $94,900
$50
$5,050
$10,050
$15,050
$20,050
Annual cost per person per
family
Source: Project WEAVE, 2011
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Evidence-based prevention programs save money
• On average, for every dollar invested
in these evidence-based prevention
programs nationwide…
– $6 was saved with Project Alert
– $8 was saved with Adolescent Transitions
Program
– $11 was saved with Strengthening
Families 10-14
– $35 was saved with Good Behavior Game
Hey! We can expect all of these to work with problem gambling!
Data source: Project WEAVE, 2011
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It’s ALL of us. NOT JUST programs
OR those prevention people.
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Excellent links:
Consider doing one of your assignments on a vulnerable population group we didn’t get to
explore.
National Registry of Effective
Prevention Practices (NREPP)
(SAMHSA)
“Best Intentions Aren’t Enough:
Techniques for Using Research &
Data to Develop New Evidence-
Informed Prevention Programs”
(U.S. Dept of H&HS, 2013)
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Consider doing one of your assignments on a vulnerable population group we didn’t get to
explore.
National Prevention Strategy
(U.S. Surgeon General, 2011)
Nurturing Environments
(Blog – renowned prevention experts
Tony Biglan & Dennis Embry)
Excellent links:
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preventionlane
For more info & resources, visit
preventionlane preventionlane
Thank
Connect: