OR IGINAL R ESEAR CH publ ishe d: 03 A ugust 2017 d o i: 1 0 .3 3 8 9 /f p sy g .2 0 1 7 .0 1 3 1 8 Fr ontiers in Ps ychology | www .f rontiers in.org 1 Augus t 2017 |V olume 8 |Article 1318 Ed ited b y: Ne ve n R ic ija s, Un ive rsi ty of Za gr e b, F a c u lty of Educ a tion a nd R e ha bi lit a tion Sciences , D ep artment of Behav ioral Di sorde rs, Croa tia Re vi e w e d by: Jef frey L . D er ev en s ky , McGill U niv ers ity , C anad a Da vi s K . Fong, Un ive rsi ty of M a c a u , Ch in a Ad rian Park e, Un ive rsi ty of L in c ol n , Un ite d K in gdom *Corre sponde nc e : Na ta le Ca n a le [email protected] Giacomo Lazzeri lazzeri@ unis i.it Spe ci a lt y se ct ion: Thi s art icl e was subm itt ed to Ps ychop athology , as e c tio no f th ej o u rn a l Frontiers in Ps ychology Re c e ive d: 25 Februar y 2017 Accep ted : 18 J ul y 2017 Pu b lish ed : 03 August 2017 Ci ta tion: Ca n a le N, V ie n o A , L e n zi M , G rif fit h s M D , B o rr a c c in o A , L a zz e ri G , Lem m a P, Scacchi L and Santinello M (2 0 1 7 ) In c o m e In e q u a lit y a n d Ad oles cent Gamb ling Sev erity : F in d in g s fro m a L a rg e -S c a le It a lia n Rep res entativ e Sur vey . Front. Ps ychol. 8:1318. d o i: 1 0 .3 3 8 9 /f p s yg .2 0 1 7 .0 1 3 1 8
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Nat ale Canale 1 *,A le s s ioV ie n o 1 ,M ic h e laL e n z i 1 ,M a rk D .G rif fi th s 2 ,A lb e rt oB o rr a c c in o 3 , Giacom o Lazzer i 4 *,P a tr iz ia L e m m a 3 ,L u c a S c a c c h i5 and Massimo Santinello 1 1 De pa rt m e nt of De ve lopm e nt a la nd S oc ia lP syc hol ogy , Uni ve rs ity o f P a d o va , P a d o va , It a ly, 2 In te rn a tio n a lG a m in g R e s e a rc h Un it, P syc h ol ogy De pa rtm e n t, Not tin gh a m Tr e n t Un ive rsi ty ,N o tti n g h a m , U n ite d K in g d o m , 3 De pa rt m e nt of P ubl ic He a lth a nd P a e d ia tric s , U n iv e rs ity o f Tu rin , Tu rin , It a ly, 4 De pa rt m e nt of M ol e c ul a r a nd De ve lopm e nt a lM e di c ine , CR EP S Un ive rsi ty of S ie n a – A O U S , S ie n a , It a ly, 5 De pa rt m e nt of Hum a n a nd S oc ia lS c ie nc e s, Uni ve rsi ty of V a lle d ’A o s ta , A o s ta , It a ly Backgr ound: St udi e s ha ve shown tha t pr obl e ms re la te d to a dul t ga mbl ing h ave a ge ogr a phi c a l a nd soc ia l gr a di e nt . For inst a nc e , a dul ts e xp erien cin g g am b lin g -r elated ha rms liv e in a re a s of gr e a te r de pr iv a tion; a re une mpl oy e d, an d h ave lo w er in co m e. Howe ve r, litt le is known a bout the impa c t of soc ioe c onomi c ine qua liti e s on a dol e sc e nt pr obl e m ga mbl ing. The ma in pur pose of the pr e se nt st udy wa s toi n ve st ig a te th e co n tex tu al in flu en ces o f in co m e in eq u ality o n at-ris k o r p ro bl e m ga mbl ing (ARPG) in al a rg e -s c a le n a tio n a lly re p re se n ta tiv e sa m p leo fI ta lia n ad o les cen ts . A seco n d ary aim wa s to a na ly ze the a ssoc ia tion be twe e n pe rc e iv e d soc ia l sup por t (fr om fa mi ly, pe e rs, teach ers , an d clas smates ) an d A R P G . Me th o d s : Da ta from the 2013–2014 He a lth Be ha vior in Sc hool-a ge d Chil dr e n Sur ve y (H B S C )S tu d y was u sed fo r cr o ss -s ectio n al an alys es o fA R P G. At o ta lo f2 0 ,7 9 1 1 5 -y e a r-ol d st ude nt s c ompl e te d se lf-a dmi ni st e re d que st ionna ire s.R e g io n -le ve l d a ta o n in c o m e in eq u ality (GIN I in d ex ) an d o verall wealth (GDP p er cap ita) we re re trie ve d from the Na tiona lInst itut e of St a tist ic s (Ist a t). The da ta we re a na lyzed u sin g th e mu lti-level lo g is tic re g re ss io n a n a ly sis , w ith st u d e n ts a t th e fir st le ve la n d re g io n s at th e seco n d level. Resul ts: The st udy de monst ra te d a Nor th–Sout h gr a di e nt for the pr e va len ce o f A R P G, wit h highe r pr e va le nc e of ARPG in the Sout he rn/ Isla nds/ Ce n tral R eg io n s (e.g ., 1 1 % in Si c ily )t ha n in Nor the rn Ita ly (e .g. , 2% in Aost a V a lle y). St ude nt s in re gi ons of hi gh-inc ome in eq u ality wer e sig n ifi can tly mo re lik ely th an th o se in reg ions of low-inc ome ine qua lity to b e at-ris k o r p ro b lem g amb lers (fo llo w in g ad ju stmen t fo r se x, fa mi ly st ruc tur e , fa mi ly af flu en ce, p er ceived so cial su p p o rt, an d reg io n ale w ealth ).A d d itio n a lly , p e rc e iv e d so c ia l suppor t from pa re nt s a nd te a c he rs we re ne ga tiv e ly re la te d toA R P G . Concl usi ons: In co me in eq u ality may h ave a co n tex tu al in flu en ce o n A R P G. Mo re spe c ific a lly ,li ving in re gi ons of hi ghe st inc ome ine qua litya p p e a re d tob e ap o te n tia lfa c to r th at in cr eas es th e lik elih o o d o f b eco min g an at-ris k o r p ro b lem g amb ler . F in d in g s o f th e st udy sugge st tha t we a lth di st ribut ion wi thi n soc ie tie s a ffected b y eco n o mic p o licies may in d irectly h ave an in flu en ce ad o les cen t g amb lin g b eh avio rs . K e y w o rd s : g a mb lin g , a d o le s c e n t g a mb lin g , y o u th g a mb lin g , p ro b le m g a mb lin g , in e q u a lit y , re p re s e n ta tiv e s u rv e yCa n a le e t a l. In c o m e In e q u a lity a n d A d o le sc e n t G a m b lin g
INTRODUCTION
Ga m bli n g dis or de r is a re co gn iz ed m en ta l he alt h co n dit io n tha t co m pr ise s pe rs ist en t an d re cu rr en t pr ob le m ga m bli n g ca us in g in div id ua ls sig n ifi ca n t ps yc ho lo gic al im pa irm en t an d/ or dis tre ss ( Am eric an Psyc hiatric A sso ciatio n ,2013 ). Fu rt hermore ,in many co un tri es , pr ob le m ga m bli n g am on g ad ole sc en ts ha s em er ge d as an in cr ea sin g so cia l an d pu bli c he alt h iss ue ( Volber g et al. , 20 10 ; Mo lin ar o et al. , 20 14 ; C ala do et al. , 20 16 )i n clu din g th e co un try of th e pr es en ts tu dy (i.e .,I ta ly ). D es pi te Ita lia n le gis la tio n pr oh ib iti n g m in or s fro m pa rti cipa tin g in le ga liz ed ga m bli n g, pr ev io us re se ar ch ha s sh ow n th at yo ut h ga m bli n g is a po pu la r ac tiv ity in Ita ly .F or in sta n ce ,r es ult s fro m th e E ur ope an -S ch oo l-Sur ve y-Proje ct-on-A lc oh ol-a nd-O th er -D rug s (ESP A D -I ta lia R ⃝ ), co n du cte d an n ua lly on re pr es en ta tiv e sa m ple of stu de n ts 15 –1 9 ye ar -o ld s, sh ow ed th at du rin g 20 12 ,1 8% of stu de n ts ga m ble d at le ast once a mont h on one or two gambling activitie s (frequen t ga m ble rs ; Ca n ale et al. , 20 16 b )a n d du rin g 20 13 ,6 .5 %w er e cla ss ifi ed as pr ob le m ga m ble rs ( Ca n ale et al. ,2 01 6a ). Ad ditio n ally, an an alysis of the E SP AD-It alia R ⃝ 2011 dat a sh ow ed th at th e pr ev ale n ce of at-ris k/ pr ob le m ga m bli n g w as hig her fo r ad ole scen ts livin g in m or e dis ad van ta ged re gio n s ( Gori et al., 2015 ), su gg es tin g th at pr ob le m ga m bli n g ca n als o be co n sid er ed a so cia l pr ob le m ( Re ith an d D ob bie , 20 11 ). Alt ho ug h, Gori et al. (2015) us ed soc io-c ult ura l indi ca tor s suc h as th e (i) un em pl oy m en t ra te , (ii ) n on -e n ga ge m en t ra te in E du ca tio n , E m pl oy m en t or T ra in in g (N E E T ), an d (ii i) pa rt of pe r ca pi ta G D P ex pe n de d in ga m bli n g ac tiv iti es , it did not focus on structura l determina nts of adole scent he alt h, for ex am pl e n ati on al w ea lth or in co m e in eq ua lit y (e .g ., D or lin g et al. , 2007; V iner et al., 2012 ). Re ce n tly , so cio ec on om ic in eq ua lit y ha s sh ow n to ha ve an in cr ea sin g im pa ct on ad ole sc en t he alt h (e.g., Elg ar et al. ,2 01 5 ). Additionally, stru ctu ral determinants of ad ole sc en t he alt h (e .g ., he alt h ex pe n dit ur e) ha ve be en as so ciated w ith lo w er le ve ls of pr ob ab le ga m bli n g pr ob le m s am on g re pr es en ta tiv e sa m pl es of stu de n ts liv in g in n in e E ur ope an co un tri es (A lb an ia ,C ypr us ,D en m ar k, Fin la n d, Ita ly ,L ith ua nia , Ro m an ia , Se rb ia , an d th e Un ite d K in gd om ; Mo lin ar o et al. , 2014 ). Howe ver , to date , no stu die s ha ve inve stig ated the as soc ia tion be twe en str uc tur al de te rmi na nt s of adol es ce n th ea lth , su ch as so cio ec on om ic in eq ua lit y, an d ad ole sc en t pr ob le m ga m bli n g in ge n er al, an d spe cifi ca lly in Ita ly , a co un try ch ar ac te riz ed by la rg e an d ris in g le ve ls of in eq ua lit y an d po verty. Over the la st thir ty ye ar s, It al y ha s seen an in cr ea se in in co me ineq ualitie s. A cco rding to the 2015 Lu xem bo ur g Inco m e Stu dy, Ita ly re gis te re d so m e in cr ea se (0 .0 5 to 0.1 po in t pe r ye ar ) in th e G in i In de x fro m 19 80 to 20 10 ( Th ew iss en et al. ,2 01 5 ). T he le vels of income inequality ha ve been ma gnifi ed by th e econom ic cr isi s an d ar e re fle cte d by re gio n al diff er en ce s, w ith th e m or e dis ad va nt aged are as also being th e more unequa l ( Th e W or ld Top Income s D at ab ase, 2011 ). T hu s, th e pr es en ts tu dy ex am in ed th e as so cia tio n be tw ee n str uc tu ra l de te rm in an ts of ad ole scent he alt h (i.e ., re gio n al in co m e in eq ua lit y an d G D P ) an d pr ob le m ga m bli n g in Ita ly , a co un try cha rac te riz ed by ris in g le ve ls of in eq ua lit y an d po ve rty ( Th ew iss en et al. ,2 01 5 ). P ro ble m ga m bli n g is go ve rn ed by a co m ple x se t of interrelating fa cto rs, cau se s, and determ inants ranging from bio lo gy an d fa m ily his to ry to so cia l n or m s an d ex ist in g st atu te s ( Me ss er lia n an d D er ev en sk y, 20 05 ;A bb ot t et al. ,2 01 3 ). C on se qu en tly , m an y fa cto rs m ay co m e in to pl ay in va rio us w ay s an d at diff er en t le ve ls th at to ge th er co n tri bu te to th e de ve lo pm en t an d m ain te n an ce of ga m bli n g-re la te d pr ob le m s (e .g ., bio lo gic al, ps yc ho lo gic al, or so cia l). A cc or din g to the co n ce pt ua l fra m ew or k fo r th e de ve lo pm en t of ga m bli n g in yo ut h ( Ba rn es et al. , 19 99 ) an d th e co n ce pt ua l fra m ew or k of ha rm fu lg am bli n g ( Ab bo tt et al. ,2 01 3 ), br oa de r pe rs pe cti ve s ar e im po rta n t w he n co n sid er in g pr ob le m ga m bli n g, in clu din g bo th co n te xt ua l m ac ro -le ve l fa cto rs (s oc ia l, ec on om ic , an d po litic al fo rc es ) an d in te rpe rs on al fa cto rs (e .g ., su ppo rt fro m pa re n ts, fri en ds ). T hu s, th e pr es en t stu dy pr ov id es n ew in sig ht in to th e po ss ib le co m bin ati on of in te rpe rs on al an d m ac ro -le ve lf ac to rs in ex pl ain in g th e de ve lo pm en to fa do le sc en tg am bli n g se ve rit y.Socioeconomic
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Wi th in co n te xt ua l fa cto rs , th er e is an as so cia tio n be tw ee n so cie ta l in eq ua lit y an d m an y diff er en t n eg ati ve he alt h an d so cia lo ut co m es ,s uc h as se xu al pr om isc uit y, te en ag e pr eg n an cy, vio le n ce , su bs ta n ce ab us e, cr im e, ps yc ho lo gic al an d ph ysi ca l disorder s, and life sa tis fa ction (see P ic ke tt an d W ilk in so n , 2015 for a re cent re vi ew; Elg ar et al. , 20 15 ). On the ot her ha n d, th e dis tri bu tio n of ga m bli n g pr ob le m s re fle cts th e ge og ra ph ic dis tri bu tio n of so cio ec on om ic de pr iv ati on ( Re ith , 2012 ). For inst ance ,in Au stralia, the gre ater the socioe conomi c dis ad va n ta ge of a m un ic ipa lit y, th e hig he r its n um be rs of ga m bli n g oppo rtu n iti es (e .g ., ga m in g m ac hin es ), w ith pe opl e liv in g in ar ea s of hig h de pr iv ati on spe n din g clo se to tw ic e as m uc h th e sta te’s m ea n ex pe n dit ur e on slo tm ac hin es ( Living sto ne, 2001 ). P ro ble m ga m bli n g also ha s a so cia l an d ge og ra ph ic al gr ad ie n t. Fo r in sta n ce , ad ult s ex pe rie n cin g ga m bli n g-re la ted ha rm (i) liv e in ar ea s of gr ea te r de pr iv ati on ,( ii) ar e un em plo yed , an d (iii) ha ve lo w er in co m e ( Or fo rd et al ., 2010; W ar dle et al ., 2014 ). A gr ow in g bo dy of la bo ra to ry stu die s su gg es ts th at pe opl e w ho fe el re la tiv ely de pr iv ed ha ve m or e se ve re ga m bli n g pr ob le ms ( C all an et al. ,2 00 8; H ais le y et al. ,2 00 8; Mi sh ra an d N ov ak ow sk i, 2016; Ta bri et al., 2017 ). C on sist en t w ith th e ris k-se n si tiv ity th eo ry ( Ca ra co et al. ,1 98 0 ), victims of income ineq uality eng age in gre ater risk-taking be ha vio rs ( Mi sh ra et al. , 20 14 )b ec au se in eq ua lit y fa cili ta te s th e pe rc ept io n of n ee d in th at vic tim s of ineq uality are at dist ance fro m the de sired or go al st ate or m ore pr iv ile ge d ot he rs . A lth ou gh th er e is gr ea t em pi ric al ev id en ce of an in eq ua lit y-ris k as so cia tio n at th e so cie ta l le ve l, un ex pe cte dly lit tle re se ar ch ha s stu die d w he th er in eq ua lit y at so cie ta l le ve l is as so cia ted w ith ad ole sc en t ga m bli n g. In eq ua lit y, m or e spe cifi ca lly in co me ineq uality, m ig ht be as so ciated w it h ado le scent gam bling be ca us e in co m e in eq ua lit y is re spo n sib le fo r an in te n sifi ca tio n of so cie ta l cla ss co m pe tit io n , th at w he n co m pa re d to m or e eg ali ta ria n so cie tie s, m ak es sta tu s in cr ea sin gly im po rta n tf or su rviv al ( W ilk in so n , 20 04 ; W ilk in so n an d P ic ke tt, 20 09 ). St atu s co m pe tit io n in m or e hie ra rc hic al so cie tie s in cr ea se s be ca use gr ea te r n um be rs of pe ople ar e de pr iv ed ac ce ss to su cc es s an d st atu s marker s ( W ilk in so n an d P ic ke tt, 20 09 ). Among minor s, Fr ontiers in Ps ychology | www .f rontiers in.org 2 Augus t 2017 |V olume 8 |Article 1318Ca n a le e t a l. In c o m e In e q u a lity a n d A d o le sc e n t G a m b lin g w ho ar e ac ut ely aw ar e of cla ss diff er en ce s, in eq ua lit y in in co me m ig ht in cr ea se th e so cia ld ist an ce be tw ee n su ch in div id ua ls wh o live in th e same society fostering a toug h social environmen t th at re gu la rly fe atu re s ac ts of re je cti on ,t ea sin g, an d hu m ili ati on ( Elg ar et al. ,2 00 9 ). In co m e in eq ua lit y in te n sifi es pe rc ept io n s th at an in div id ua l is unju stly re so ur ce dis ad vant aged relative to ot her s. Su ch re la tiv e de pr iv ati on is ac co m pa n ie d by fe eli n gs of an ge r an d re sentment ( Crosby , 19 76 ; Smi th et al. , 20 12 )t ha tm ot iv ate s a de sir e to m ov e up th e so cia l la dd er, es pe cia lly in div id ua ls lo wer down th e income distribution ( Wi lk in so n an d P ic ke tt, 20 09 ). T hu s, it po ss ib le th at w he n in div id ua ls pe rc eiv e th em se lv es as un fa irl y de pr iv ed th ey m ay als o en ga ge in m ala da pt iv e be ha vio rs to ad va n ce th eir fin an cia l po sit io n . Fo r ex am pl e, in div id ua ls w ho fe el re la tiv ely de pr iv ed ar e apt to ga m ble in an att em pt to qu ic kly re du ce th eir pe rc eiv ed fin an cia l dis ad va n ta ge (s ee Ca lla n et al. , 20 15 fo r a m eta -a n aly sis ). Mo re re ce n tly , Ta br i et al. (2017) sh ow ed th at re la tiv e de pr iv ati on is m os t lik ely to le ad to dis or de re d ga m bli n g w he n in div id ua ls pe rc eiv ed a lo w pe rs on al ca pa cit y fo r upw ar d ec on om ic m ob ili ty via co n ve n tio n al m ea n s (e .g ., pr of es sio n al de ve lo pm en ta cti vit ie s). In th is cont ext , ga m bli n g m ay be co n sid er ed by ad oles ce n ts as a m ea n s: (i) to he lp pe opl e m ee t th eir n ee ds an d w an ts an d/ or off se t fe eli n gs of de pr iv ati on th ro ug h th e po ss ib ilit y of fin an cia lw in df all ( Mi sh ra et al., 2017 ); an d/ or (ii ) to be a pa th to upw ar d ec on om ic m ob ili ty ( Ta br i et al. ,2 01 5 ). T hu s, th e pr in cipa l aim of th e pr es en t stu dy was to veri fy th e as soc ia tion bet ween inc ome inequa lit y and ad ole sc en tpr ob le m ga m bli n g at a so cie ta lle ve l( re gio n s).
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So cia l su ppo rt ha s be en cit ed as a pr ot ec tiv e fa cto r ag ain st a w id e ra n ge of ris k be ha vio rs , in clu din g ad ole sc en t pr ob le m ga m bli n g. So cia ls uppo rt pr ov id ed by in div id ua ls an d in sti tu tions is de fin ed as in te rpe rs on al re la tio n sh ips th at ar e ab le to in flu ence th e w ay in w hic h in div id ua ls liv e. Su ppo rti ve re la tio n sh ips w ith ot he rs (i.e ., so cia l su ppo rt) ha ve be en co n ce pt ua liz ed as re so ur ce s th at pr om ot e su cc es sfu la da pt ati on du rin g ad ole sc ence ( C om pa s et al. , 19 95 ; Ju an g an d Sil be re ise n , 19 99 ; Sa un de rs et al. , 20 04 ; Mo or et al. , 20 15 ). Du ring adole scence , there ar e se ve ra l po te n tia l so ur ce s of so cia l su ppo rt (e .g ., pa re n ts, sibling s, friend s, cla ssmate s, and te ac her s) and they are sensitive to the inter co nne ctio ns betw een the se so ur ce s ( Benh ori n and Mc M ah on , 20 08 ). E xa m pl es of so cia l su ppo rt in clu de pa re n t’s clo sene ss, m onito ring and caring , te ac her s’ intere st in th eir stu de n ts, an d fri en ds ’ su ppo rti ve n es s ( Je ss or et al. , 20 03 ). P er ce iv ed so cia l su ppo rt is fre qu en tly us ed in th e stu dy of ad ole sc en td ev elo pm en ta s a pr ox y fo r go od so cia ls uppo rt ( W ill s an d Shin ar, 2000 ). Su ch su ppo rt de n ot es th e pe rc eiv ed ex te n t by pe opl e to w hic h in div id ua ls w ith in th eir so cia l n etw or ks ca n pr ov id e so cia l su ppo rt ( Demaray and M ale cki, 2002 ). Hig h so cia l su ppo rt m ay pr ot ec t ag ain st ga m bli n g-re la te d ha rm s by pr om ot in g so cia l en vir on m en ts w he re by ad ole sc en ts fe el ac ce pt ed an d w an te d w ith ou t te as in g, re je cti on ,a n d hu m ili atio n re la te d to so cia l co m pa ris on s (e .g ., re du cin g sta tu s co m pe titio n wi th in soc iet y). P re vio us stu die s ha ve fo un d th at so cia l su ppo rt fro m sc ho ol, pa re n ts, an d fri en ds all in flu en ce ad ole sc en t pr ob le m ga m bli n g. Fo r ex am pl e, n on -g am ble rs an d so cia l ga m ble rs pe rc eiv e th ey ha ve m or e so cia l su ppo rt fro m pa re n ts an d fri en ds (e .g ., ha vin g pa re n ts an d pe er s w ho pr ov id ed su ppo rt an d en co ur ag em en t) th an at-ris k an d pr ob le m ga m ble rs ( Ha rd oo n et al. , 20 04 ; Mo lin ar o et al. ,2 01 4; C an ale et al. ,2 01 7 ). Similarly, hig h forms of so cia l su ppo rt fro m sc ho ol an d te ac he rs ha ve sh ow n to be pr ot ec tiv e ag ain st ga m bli n g pa rti cipa tio n am on g 14 –1 6-ye ar -o ld Fi nni sh adole sc ent s ( Rä sä n en et al. , 20 16 ). Mo re spe cifi ca lly , it w as fo un d th at ha vin g te ac he rs w ho pr ov id ed su ppo rt an d en co ur ag em en t w ith in a su ppo rti n g sc ho ols se tti n g (e .g ., sc hools he lpi n g stu de n ts w he n th ey n ee d it) re du ce d th e od ds of be in g en ga ge d in ga m bli n g ac tiv iti es ( Rä sä n en et al. , 20 16 ). It appe ar s th at su ppo rti ve fa m ilie s, su ppo rti ve sc ho ols , to ge th er w ith su ppo rti ve pe er s, ar e cr uc ia lin pr ot ec tin g ad ole sc en ts from ga m bli n g-re la te d ha rm s. T he se so cia l re la tio n sh ips , th at ha ve be en fo un d to diff er be tw ee n th e m os t an d le as t un eq ua lr eg io n s ( D e C le rc q et al. ,2 01 6; N g Fa t et al. ,2 01 6 ), m ig ht also m od er ate th e in flu en ce of in eq ua lit y ac t on ad ole sc en t ga m bli n g se ve rity. In de ed , th e la ck of so cia l su ppo rt m ig ht ex ac er ba te th e im pa ct of in co m e in eq ua lit y on ad ole sc en t pr ob le m ga m bli n g. T hu s, th e pr es en t stu dy in te n de d to cla rif y th e ad dit iv e ro le of so cial su ppo rt an d m ac ro -le ve l fa cto rs re la te d to ad ole sc en t ga m bli ng se verity.T
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C on sis te n t w ith th e lit er atu re re vie w ed , th e pr in cipa l aim of th e pr es en t stu dy w as to es ta bli sh th e re la tio n sh ips be tw ee n at-ris k or pr ob le m ga m bli n g (A RPG ) an d in co m e in eq ua lit y. It is hy po th es iz ed th at in re gio n s w ith hig he r le ve ls of in co m e in eq ua lit ie s, ad ole sc en ts w ou ld re po rt hig he r le ve ls of A RP G co m pa re d to m or e eg ali ta ria n re gio n s. A se co n da ry aim w as to an aly ze th e as so cia tio n be tw ee n pe rc eiv ed so cia l su ppo rt (fr om fa m ily ,pe er s, te ac he rs ,a n d cla ss m ate s) an d A RP G .I t w as als o hy po th es iz ed th at ad ole sc en ts w ho pe rc eiv ed m or e so cia l su ppo rt w ou ld be le ss lik ely to re po rt hig he r le ve ls of A RP G th an th os e w ho pe rc eiv ed le ss so cia l su ppo rt. Fin all y, an ot he r aim of th e pr es en t stu dy w as to ex pl or e po ss ib le in te ra cti on s be tw ee n pe rc eiv ed so cia l su ppo rt an d re gio n -le ve l in eq ua lit y in in flu en cin g pr ob le m ga m bli n g. It w as hy po th es iz ed th at th e im pa ct of liv in g in a m or e un eq ua l re gio n on A RP G w ou ld be str on ge r fo r ad ole sc en ts pe rc eiv in g lo w er le ve ls of so cia l su ppo rt.METHODS
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Th e da ta w er e co lle cte d in th e Ita lia n 20 13 –2 01 4 H ea lth B eh avior in Sc ho ol-aged C hildren (HB SC ) su rvey. An aim of the HB SC stu dy (s ee ht tp: //w w w .h bs c.o rg fo r m or e de ta ils ) w as to id en tif y be ha vior s and socia lf actor s th at infl uence be ha viora la ddi ctio ns (in clu din g A RP G ) in yo ut h. In Ita ly , stu de n ts fro m G ra de 6 (11-ye ar old s) to Grade 10 (15-ye ar old s) se cond ary sc hools w er e in vit ed to pa rti cipa te . B ec au se as se ss m en ts of ga m bli n g were only inc luded in th e 15 -y ea r-old s’que st ionna ire s, 11 -a n d 13 -y ea r-o ld stu de n ts w er e ex clu de d fro m th e pr es en t stu dy . T he sa m ple co m pr ise d 20 ,7 91 stu de n ts (m ale , 50 .3 %) n es te d wi th in 1,0 50 sc hools and 21 Ita lia n re gi ons/c iti es (A bruz zo, A ost a Fr ontiers in Ps ychology | www .f rontiers in.org 3 Augus t 2017 |V olume 8 |Article 1318Ca n a le e t a l. In c o m e In e q u a lity a n d A d o le sc e n t G a m b lin g V all ey , B as ilic ata , C ala br ia , C am pa n ia , E m ilia -Ro m ag n a, Fr iu li V en ez ia G iu lia , L ati um , L ig ur ia , L om ba rd y, M ar ch es , Mo lis e, P ie dm on t, P ug lia , Sic ily , Sa rd in ia , T re n tin o, T us ca n y, Um bria, an d V en eto )1 .A ra n do m sa m pl e of sc ho ols w as dr aw n fro m th e N ati on al Sc ho ol O ffi ce .T he av er ag e pa rti cipa tio n ra te by stu de nts w as 91 %. N ati on all y re pr es en ta tiv e sa m ple s of stu de n ts in G ra de 10 pa rti cipa te d in th e pr es en t stu dy .T he se lf-co m pl eti on que sti onna ire s we re admi ni ste re d by clas sroom te ac he rs du ring norma l sc hool da y clas se s. T he que stionna ire took ∼ 50 m in to co m pl ete . W rit te n in fo rm ed co n se n t w as ob ta in ed fro m th e pa re n ts of th e stu de n ts of th is stu dy an d all pa rti cipa n ts w er e as su re d of th e co n fid en tia lit y of th eir re spo n se s. T he Un iv er sity of T ur in ’s E th ic s C om m itt ee gr an te d eth ic al appr ov al fo r th e stu dy .
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T he cu rr en t stu dy co m pr ise s a se co n da ry da ta an aly sis of th e It al ian HB SC 2013–2014 su rvey w hic h in cl ud es qu estio n s rel ated to a n um be r of diff er en t be ha vio rs .T he re lia bil ity an d va lid ity of th es e sc ale s as se ss in g su ch be ha vio rs am on g te en ag er s in va rious co untrie s is w ell-est ablis hed ( La zz er ie ta l., 20 13 ). Dependent V ar iable A t-r isk or pr ob le m ga m bli n g (A RP G ) w as as se ss ed w ith th e 12 -it em So ut h O ak s G am bli n g Sc re en -Re vis ed fo r A do le sc en ts SO G S-R A (It ali an ve rs ion: Ch ie si et al. , 20 13 ). P ar tic ipa n ts w er e pr es en te d w ith 12 ite m s as se ss in g n eg ati ve co n se qu en ce s as so cia te d w ith ga m bli n g be ha vio r ov er a pa st-ye ar tim efr am e on a bin ar y “y es -n o” sc ale sc or ed 1 or 0, re spe cti ve ly . T he ori gi na l sc ori ng sy st em of Wi n te rs et al. (1 99 5) was used to es tim ate pr ev ale n ce ra te s of A RP G du rin g th e pa st 12 m on th s. Th e sc or in g w as as fo llo w s: 0– 1 = “n o ga m bli n g pr ob le m ,” 2– 3 = “at-risk gam blin g,” an d 4 or m or e = “pr ob le m ga m bli n g.” In pr ev io us stu die s, A RP G ha s be en co n sid er ed as pa rt of a w id er spe ctr um of pr ob le m ati c ad ole sc en t ga m bli n g ( Potenza et al., 2011 ). C on sis te n t w ith pr ev io us ly us ed gr ou ps , th ey w er e dic ho to m iz ed in to “a t-r isk -pr ob le m ati c ga m ble rs” an d “n on -pr ob le m ati c ga m ble rs” ( Wi ck w ire et al. , 20 07 ; P ot en za et al. , 2011 ). T he instru ment had adeq uate internal relia bility (α = 0.78; 95% C I = 0.78–0.80). In a re cent system atic re view , Ed gren et al. (2016) fo un d th at m os t stu die s ex am in in g ad ole sc en t ga m bli n g us ed th e SO G S-R A as th e pr im ar y A RP G in str um en t. In ad dit io n , item s on freq uency of gam bling invo lvem ent (in their lif eti me an d in the la st 30 days) w ere also in clu ded , as w ell as the number of ga mbling oc casions (“ During th e last 30 da ys/I n yo ur lif eti m e, on ho w m an y oc ca sio n s [if an y] ha ve yo u pa rti cipa te d in ga m bli n g ac tiv iti es ?” — se ve n opt io n s ra n gin g fro m “n ev er ”t o “30 or m or e days ”). A bin ar y var ia ble w as cr eated de scr ib in g th e ga m bli n g lif eti m e fre qu en cy (0 = ne ver; 1 = from “1 –2 da ys ” to “30 or m or e days ”). 1 A ll Ita lia n re gio n s w ere in vo lv ed , bu t th e T re n tin o R eg io n pro vid ed dat a for on ly tw o cit ie s: B olz an o an d T re n to . T hu s, th e pre se n t stu dy sh ow s da ta fo r 19 re gio n s (A bru zz o, A os ta V alle y, B as ili ca ta ,C ala bri a, C ampa n ia ,E mi lia -R oma gn a, Fri uli V en ez ia G iu lia , L ati um, L ig uri a, L omb ard y, M ar ch es , M oli se , P ie dmo n t, P ug lia ,S ic ily ,S ard in ia ,T us ca n y, Umb ri a, an d V en eto ) an d tw o cit ie s (B olz an o an d T re n to ). In d ivid u a l-L e ve l V a ria b le s Fa m ily st ru ct u re Fa m ily str uc tu re w as as se ss ed ut iliz in g re spo n se s to th e sin gle qu es tio n “W hic h of th e fo llo w in g pe opl e liv e in th e sa m e ho use ho ld w it h yo u?” to in dic ate stu den ts w ho lived w it h tw o bio lo gic al or ad opt iv e pa re n ts or th os e th at liv ed in ot he r ty pe s of fa m ily se t-u p (e .g ., sin gle -pa re n tf am ilie s; Ha m ilt on et al. ,2 01 4 ). Fa m ily w ea lth Fa m ily w ea lth w as as se ss ed usi n g th e Fa m ily A ffl ue n ce Sc ale (F A S) ( Boy ce et al. , 20 06 ). T he FA S re fe rs to fa m ilia l (m ate ria l) we alt h by ask ing que st ions rela ting to number of fa mi ly holi da ys ov er th e pa st 12 m on th s, th e n um be r of ho use ho ld ca rs , th e n um be r of ho m e co m pu te rs in th e ho use , an d w he th er pa rti cipa n ts ha d a be dr oo m of th eir ow n .S co re s ra n ge d fro m ze ro to se ve n an d w er e div id ed in to th re e gr ou ps. St ud en ts sc or in g be tw ee n ze ro an d fo ur w er e pl ac ed in to th e “lo w -a ffl ue n ce ” ca te go ry , th os e sc or in g be tw ee n fiv e an d six w er e pl ac ed in to th e “m od er ate -a ffl ue n ce ” gr ou p, an d th os e w ho sc or ed se ve n w er e pl ac ed in th e “h ig h-affl ue n ce ” ca te go ry . P re vio us stu die s in dic ate d th at co m pa re d to ot he r fa m ily affl ue n ce m ea su re s re ly in g on pa re n ta l oc cu pa tio n , ed uc ati on an d/ or in co m e, th e FA S ha s su pe rio r cr ite rio n va lid ity an d is m uc h le ss aff ec te d by n on re spo n se bia s ( Boy ce et al. , 20 06 ; Curri e et al. , 20 08 ). So cia ls uppo rt w as m ea su re d usi n g a pe rc eiv ed su ppo rt de fin iti on of so cia l su ppo rt w ith th e fo llo w in g fo ur so ur ce s of su ppo rt: te ac he rs ,c la ss m ate s, pa re n ts, an d fri en ds . Pe rc ei ve d cla ss m a te su p p o rt P er ce iv ed cla ss m ate su ppo rt w as as se ss ed w ith th re e ite m s fro m th e T ea ch er an d C la ss m ate Su ppo rt Sc ale ( Tor sheim et al., 2000 ): “T he stu de n ts in m y cla ss en jo y be in g to ge th er,” “Mo st of th e stu de n ts in m y cla ss ar e kin d an d he lpf ul, ” an d “O th er stu de n ts ac ce pt m e as I am .” Ite m s w er e ra te d on a 5-po in tf re qu en cy sc ale fro m (1 ) “s tro n gly ag re e” to (5 ) “s tro n gly dis ag re e.” Re spo n ses were re ver se coded and th en th e th ree items were avera ged. H ig he r sc or es in dic ate a hig he r le ve l of pe rc eiv ed su ppo rt fro m cla ss m ate s. A lph a re lia bil ity fo r th e 3-ite m sc ale w as 0.7 6 (95% C I = 0.75–0.77). Pe rc ei ve d te a ch er su p p o rt P er ce iv ed te ac he r su ppo rt w as as se ss ed usi n g th re e ite m s: “I fe el m y te ac he r ac ce pt s m e as Ia m ,” “I fe el th at m y te ac he rs ca re ab out m e as a pe rs on ” an d “I fe el a lo t of tru st in m y te ac he rs” (e .g ., Klem era et al., 2016; B jereld et al., 2017 ). A lph a re lia bil ity fo r th e 3-ite m sc ale w as 0.7 9 (9 5% C I = 0.78–0.80). Hig her sco re s in dic ate a hig he r le ve lo fpe rc eiv ed su ppo rt fro m te ac he rs . Pe rc ei ve d fr ie n d su p p o rt P er ce iv ed fri en d su ppo rt w as as se ss ed usi n g fo ur ite m s fro m a su b-sc ale of th e Mu lti dim en si on al Sc ale of P er ce iv ed So cia l Su ppo rt ( Zimet et al., 1988 ): “My fri en ds re all y try to he lp m e,” “I ca n co un t on m y fri en ds w he n th in gs go w ro n g, ” “I ha ve fri en ds wi th wh om I ca n sh are my joy s and sorrows ” and “I ca n ta lk ab ou t m y pr ob le m s w ith m y fri en ds .” Ite m s w er e ra te d on a 7-po in tf re qu en cy sc ale fro m (1 )“ str on gly dis ag re e” to (7 )“ strongly dis ag re e.” A lph a re lia bil ity fo r th e 4-ite m sc ale w as 0.9 0 (9 5% Fr ontiers in Ps ychology | www .f rontiers in.org 4 Augus t 2017 |V olume 8 |Article 1318Ca n a le e t a l. In c o m e In e q u a lity a n d A d o le sc e n t G a m b lin g CI = 0.8 9– 0.9 1) . Re spo n se s w er e av er ag ed in or de r to as se ss pe rc eiv ed fri en d su ppo rt. Pe rc ei ve d fa m ily su p p o rt P er ce iv ed fa m ily su ppo rt w as as se ss ed by fo ur ite m s fro m a su b-sc ale of th e Mu lti dim en sio n al Sc ale of P er ce iv ed So cia l Su ppo rt ( Zimet et al., 1988 ): “My fa m ily re all y tri es to he lp m e,” “I ge t th e em ot io n al he lp an d su ppo rt I n ee d fro m m y fa m ily ,” “I ca n ta lk ab ou t m y pr ob le m s w ith m y fa m ily ” an d “My fa m ily is wi lli ng to help me ma ke de cisi ons. ” Items were ra ted on a 7-po in tf re qu en cy sc ale fro m (1 )“ str on gly dis ag re e” to (7 )“ strongly dis ag re e.” A lph a re lia bil ity fo r th e 4-ite m sc ale w as 0.8 9 (9 5% CI = 0.8 9– 0.9 0) . Re spo n se s w er e av er ag ed in or de r to as se ss pe rc eiv ed fa m ily su ppo rt. Regi onal -Lev el V ar iabl es D ata on Ita lia n re gio n al w ea lth (g ro ss do m es tic pr od uc t [G D P ] pe r ca pi ta ) an d in co m e in eq ua lit y (G in i in de x) w er e ta ke n fro m th e N ati on al In sti tu te of St ati sti cs (IS T A T, se e w w w .is ta t.it). T he se da ta ar e pr es en te d in Ta b le 1.T he G in i in de x de n ot es th e dis tri bu tio n of in co m e or co n su m pt io n am on g cit iz en s in a so cie ty , an d ra n ge s th eo re tic all y fro m 0 (w he re all pe rs on s ha ve eq ua l in co m e; pe rfe ct eq ua lit y) to 1 (w he re on e pe rs on ha s all th e in co m e an d th e re st ha ve n on e; pe rfe ct in eq ua lit y) . W ith th e aim of fa cili ta tin g lo gis tic re gr es sio n an aly sis , reg io n s w er e gr ou pe d in to appr ox im ate th ird s of lo w ,m ed iu m ,a n d hig h inco m e ineq uality ba sed on Gini indice s (e.g., Elg ar et al. ,2 00 5 ), as pr es en te d in Ta b le 1.
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P re va le n ce of A RP G w as co m pa re d by ge n de r usi n g a χ 2 te st. Fo r the χ 2 te st, th e ph i (! ) co effi cie n t is re po rte d, wh ere va lue s bet ween − 0.3 and + 0.3 are tre ated as trivial as so cia tio n s. H ie ra rc hic al L in ea r Mo de lin g (H L M) so ftw ar e ver sion 7 ( Ra ud en bu sh et al. , 20 11 ) w as use d to te st m ult ile ve l lo gis tic re gr es sio n m od els of th e eff ec ts of in co m e in eq ua lit y on A RP G . Mu lti le ve l sta tist ic al m od els ar e pa ra m etr ic m od els va ry in g at m or e th an on e le ve l. T he se ar e es pe cia lly use fu l fo r re se ar ch de sig n s in w hic h da ta ar e ope ra tio n ali ze d ac ro ss m ore th an on e le ve l( in th e pr es en ts tu dy ’s ca se ,in div id ua ls w er e ne sted w ith in re gio n s). H ie ra rc hic al lin ea r m od els pe rm it va ria n cea n d co va ria n ce co m po n en ts to be pa rti tio n ed ac ro ss le ve ls as w ell as th e m od eli n g of su ch va ria n ce by th e in clu sio n of m ult ile ve l pr ed ic to rs (e .g ., Mo lin ar o et al. ,2 01 4; V ie n o et al. ,2 01 5, 20 16 ). D ue to th e dic ho to m ou s n atu re of th e de pe n de n t va ria ble A RP G (y es /n o) , th e m od els w er e an aly ze d w ith hie ra rc hic al ge n er ali ze d lin ea r m od el (H G L M) usi n g a B er n ou lli sa m pl in g TA B L E 1 | D e sc rip tiv e st a tis tic s fo r th e It a lia n re g io n a lv a ria b le s: D a ta p ro vid e d fo r re g io n s/c itie s (n = 21) # . Count ry n Gini in d ex GDP pe r cap ita A t-ris k o r p ro b le m g a mb lin g % (n ) G a mb lin g fr e q u e n c y % (n )— life time p re v a le n c e To ta l B o y s G ir ls χ 2 ! To ta l B o y s G ir ls χ 2 ! LO W INCO M E INEQ UA LI TY Aos ta V alley 521 0.246 37.00 2.0 (11) 4.0 (8) 1.0 (3) 3.93 * 0. 09 29. 0 (150) 46. 0 (105) 15. 0 (45) 57. 65 *** 0. 33 Bol zano 729 0. 260 39. 90 2. 0 (13) 3. 0 (10) 1. 0 (3) 6. 9 ** 0. 10 41. 0 (299) 48. 0 (145) 36. 0 (154) 10. 86 ** 0. 12 Friuli V enezia Giulia 1,005 0.260 27.90 5.0 (46) 7.0 (37) 2.0 (9) 11. 44 ** 0. 11 33. 0 (331) 44. 0 (248) 19. 0 (83) 73. 02 *** 0. 27 Tr e n to 7 9 6 0 .2 7 0 3 3 .9 0 2 .0 (1 6 ) 3 .0 (1 2 ) 1 .0 (4 ) 4 .0 0* 0. 07 28. 0 (224) 36. 0 (144) 20. 0 (80) 25. 95 *** 0. 18 Ve n e to 2 ,4 4 7 0 .2 7 0 3 0 .0 0 4 .0 (8 9 ) 6 .0 (6 3 ) 2 .0 (2 6 ) 1 7 .6 8 *** 0. 09 30. 5 (744) 45. 0 (530) 17. 0 (214) 224. 59 *** 0. 30 MEDIUM INCOME INEQUAL IT Y Ab ruz zo 737 0.300 23.10 11.0 (75) 18.0 (64) 3.0 (11) 39.95 *** 0. 24 44. 0 (321) 66. 0 (245) 21. 0 (76) 150. 68 *** 0. 46 Basi licat a 576 0. 280 18. 70 9. 0 (43) 16. 0 (39) 2. 0 (4) 32. 23 *** 0. 25 41. 0 (231) 63. 0 (176) 19. 0 (55) 117. 79 *** 0. 45 Emilia-R o mag n a 1 ,1 1 6 0 .2 9 0 3 2 .5 0 6 .0 (6 4 ) 1 0 .0 (5 6 ) 2 .0 (8 ) 3 0. 22 *** 0. 17 35. 0 (390) 48. 5 (293) 19. 0 (97) 106. 02 *** 0. 31 Lom bar dy 1,474 0.300 35.00 5.0 (75) 9.0 (65) 2.0 (10) 37.01 *** 0. 16 44. 0 (653) 58. 0 (445) 30. 0 (208) 117. 00 *** 0. 29 Mar ch e 9 7 8 0 .2 8 0 2 5 .2 0 5 .0 (5 0 ) 1 1 .0 (4 3 ) 1 .0 (7 ) 4 1 .4 8*** 0. 21 39. 0 (379) 58. 0 (241) 25. 0 (138) 112. 85 *** 0. 34 Mo lis e 8 4 5 0 .2 9 0 2 0 .3 0 9 .0 (7 1 ) 1 5 .0 (6 1 ) 3 .0 (1 0 ) 3 4 .9 9*** 0. 21 38. 0 (319) 59. 0 (262) 14. 0 (57) 174. 55 *** 0. 45 Pied mont 1,004 0.286 27.80 6.0 (53) 9.0 (43) 2.0 (10) 21.70 *** 0. 15 33. 0 (332) 49. 0 (242) 18. 0 (90) 108. 79 *** 0. 33 Puglia 1,070 0.310 16.90 9.0 (89) 15.0 (77) 2.0 (12) 47.42 *** 0. 22 40. 0 (426) 56. 0 (306) 23. 0 (120) 119. 80 *** 0. 34 Tu sc a n y 1 ,0 3 0 0 .2 8 0 2 8 .9 0 3 .0 (2 6 ) 5 .0 (2 3 ) 1 (3 ) 1 7 .8 4*** 0. 14 32. 0 (331) 49. 0 (240) 17. 0 (91) 115. 07 *** 0. 34 Um bri a 1, 065 0. 300 23. 90 5. 0 (46) 7. 0 (40) 1. 0 (6) 20. 63 *** 0. 14 38. 0 (404) 56. 0 (319) 17. 0 (85) 167. 70 *** 0. 40 HI GH INCOME INEQUA LI TY Latium 955 0.350 31.70 7.0 (63) 11.0 (56) 2.0 (7) 33.95 *** 0. 19 41. 0 (387) 56. 0 (285) 23. 0 (102) 112. 17 *** 0. 34 Liguria 1,087 0.320 29.00 5.0 (51) 8.0 (40) 2.0 (11) 19.26 *** 0. 14 33. 0 (355) 48. 0 (253) 18. 0 (102) 106. 37 *** 0. 31 Ca m pa n ia 841 0. 350 16. 80 9. 0 (72) 14. 0 (60) 3. 0 (12) 25. 74 *** 0. 18 48. 0 (400) 72. 0 (328) 19. 0 (72) 240. 60 *** 0. 54 Ca la br ia 883 0. 320 16. 20 10. 0 (81) 16. 0 (68) 3. 0 (13) 37. 70 *** 0. 22 46. 0 (404) 65. 0 (299) 25. 0 (105) 137. 53 *** 0. 40 Sicily 843 0.360 17.00 11.0 (84) 19.0 (77) 2.0 (7) 59.02 *** 0. 28 43. 5 (365) 66. 0 (288) 19. 0 (77) 189. 44 *** 0. 48 Sar d inia 789 0.320 19.80 6.0 (40) 9.0 (32) 2.0 (8) 17.51 ** 0. 15 33. 0 (261) 51. 0 (194) 17. 0 (67) 104. 02 *** 0. 37 *** p < 0 .0 0 1 ;** p < 0 .0 1 ;* p < 0 .0 5 ; # T h e n u m be r o f re g io n a lle ve ls tota ls 21 be c a u s e th e Tr e n ti n o da ta c om pr is e d tw o di ffe re n t ge ogr a ph ic a re a s (i.e ., B ol za n o a n d Tr e n to) . Fr ontiers in Ps ychology | www .f rontiers in.org 5 Augus t 2017 |V olume 8 |Article 1318Ca n a le e t a l. In c o m e In e q u a lity a n d A d o le sc e n t G a m b lin g model wi th th e followi ng logi tli nk func tion: η ij k = log [! ij k /(1 − ! ij k)] (1) wh ere η ij k is th e lo g of th e od ds of be in g in th e gr ou p re po rti n g ga m bli n g an d ! ij k is th e pr ob ab ilit y of be in g m em be r of th is gr ou p. T he in iti al an aly se s co m pr ise d an es tim ati on of th e unc ondi tiona l mode l, wh ere γ 00 re pr es en te d th e av er ag e lo g-odd s of bei ng in th e group of ga mbler s from th e 21 Ita lia n re gio n s/c iti es ta ke n in to ac co un t. N ex t, th e an aly sis in vo lved sim ult an eo us ly fit tin g tw o re gr es sio n m od els fo r th e de pe n de n t va ria ble : a w ith in -r eg io n m od el an d a be tw ee n -r eg io n s m od el. T he w ith in -r eg io n (L ev el 1) , be tw ee n in div id ua l-le ve l va riab le s an d A RP G w as ex am in ed (Mo de l1 ) fo r stu de n t iin re gio n j, via th e fo llo w in g eq ua tio n : η ijk = π 0j + π 1j (M ale ij) + π 2j (F amily We alt h ij) + π 3j (Ot her Fa m ily T ype s ij) + π 4j (P er ce iv ed Fa m ily su ppo rt ij) + π 5j (P er ce iv ed P ee r su ppo rt ij) + π 6j (P er ce iv ed T ea ch er su ppo rt. ij) + π 7j (P er ce iv ed C la ss m ate su ppo rt ij) + e ij wh ere η ij is the lo g of the odd s of being in the gro up of ga m ble rs , π 0j is th e in te rc ept , π 1 − 7j ar e th e pa ra m ete rs of th e slo pe s fo r in div id ua lpr ed ic to rs ,a n d e ij is the le vel-1 erro r term . Th e be tw ee n -re gio n (L ev el 2) m od el es tim ate d th e in flue n ce of th e G IN I in de x an d pe r ca pi ta G D P (a t th e re gio n al le ve l, Mo de l 2) ex er te d on stu de n ts’ A RP G : π 0j = β 00 + β 01 (GINI j) + β 02 (GD P j) + r 0j (2) E ac h of th e L ev el-2 pr ed ic to rs w er e gr an d m ea n ce n te re d, an d all th e L ev el 1 slo pe s w er e co n tro lle d fo r th eir va ria tio n s (i.e .,f re e to ha ve diff er en te ff ec ta cr os s re gio n ).
RESUL
TS
A m on g th e n ati on all y re pr es en ta tiv e sa m ple of Ita lia n ad ole sc en ts, th e lif eti m e pr ev ale n ce of ga m bli n g w as 37 .0 %. B oy s sh ow ed hig he r ra te s of lif eti m e ga m bli n g in vo lv em en t co m pa re d to gir ls in ea ch re gio n (s ee Ta b le 1) . T he re po rte d le ve ls of A RP G ar e 6.0 % (to ta l sa m pl e pr ev ale n ce ) w ith bo ys re po rti n g hig he r le ve ls of A RP G (1 0%) th an gir ls (2 %) . In pa rti cu la r, th e pr es en t stu dy de m on str ate d a N or th –S ou th gr ad ie n t fo r th e pr ev ale n ce of A RP G , w ith hig he r pr ev ale n ce of A RP G in th e So ut he rn /Is la n ds /C en tra l Re gio n s (e .g ., 11 % in Si cily ) th an in Nort he rn Ita ly (2 % in V alle d’A os ta ; Fi g u re 1). Wi th re ga rd to ge n de r dis tri bu tio n fo r ea ch re gio n , at-ris k an d pr ob le m ga m ble rs w er e m or e lik ely to be m ale an d le ss lik ely to be fema le (see Ta b le 1). Ta b le 2 re po rts th e m ea n s, sta n da rd de via tio n s, an d biv ar ia te co rrelatio ns fo r the individu al and re gio nal varia ble s. W ith re ga rd to th e so cia l su ppo rt, stu de n ts re po rte d re ce iv in g m or e su ppo rt fro m pe er s (M = 5.86; SD = 1.47) th an fro m the fam ily (M = 5.76; SD = 1.54); and fro m cla ssm ate s (M = 3.78; SD = 0.81) th an from te ac her s (M = 3.37; SD = 0.81). All biv ariate co rrelatio ns am on g stu dy varia ble s (at the in divid ual an d re gio n al le vel )w er e in th e hy po th es iz ed dir ec tio n . T he H L M m od els ar e re po rte d in Ta b le 3.T he fir st ste p in H L M in vo lv ed fit tin g an un co n dit io n al m od el (e m pt y m od el) FI GURE 1 | R e g io n a lp re va le n c e o f A R P G in 1 5 -y e a r-o ld It a lia n st u d e n ts (n = 20, 791). ARPG (at -ri sk or pr obl em gam bl ing); Dat a report ed for Tr e n tin o-A lto Ad ige region ar e the mean b etween two d iffer ent geograp hic a re a s (T re n to a n d Bol zano). an d co m pa rin g th e em pt y m od el at on e le ve l (in div id ua ls) w ith th e em pt y m od el at tw o le ve ls (r eg io n s). T he po pu la tio n -a ve ra ge es tim ate γ 00 re pr es en te d th e av er ag e lo gs od ds of A RP G in a re gion (γ 00 = –2.812). T his m eans th at fo r a re gio n w it h a ra n do m eff ec t u 00 = 0, th e ex pe cte d od ds of be in g in th e A RP G group wa s 0.094. Given th e estimate of τ 00 = 0.263 at the re gio nal le ve l, it w as ex pe cte d th at 95 % of th e re gio n w ou ld ha ve lo g od ds between − 3.817 and − 1.8 07 , co rr es po n din g to a pr ob ab ilit y of re po rti n g A RP G be tw ee n 2.1 an d 14 .3 %. T he re lia bil ity fo r th e unc ondi tiona lmode lwas 0.9 15 at th e re gi ona lle ve l. T he w ith in -r eg io n m od el (Mo de l 1) in clu de d in div id ua l va ria ble s. In th e to ta l sa m pl e m od el, m ale s w er e m or e lik ely to be at-ris k or pr ob le m ga m ble rs . A do le sc en ts n ot liv in g w ith tw o bio lo gic al or ad opt iv e pa re n ts w er e sig n ifi ca n tly m or e lik ely to be A RP G s th an ad ole sc en ts liv in g w ith tw o bio lo gic al or ad opt iv e pa re n ts. A dd iti on all y, ad ole sc en ts w ho liv ed in m or e affl ue n t fa m ilie s w er e sig n ifi ca n tly le ss lik ely to be A RP G s th an th os e in a lo w er FA S fa m ily . W ith re ga rd to so cia l su ppo rt va ria ble s, stu de n ts w ho pe rc eiv ed m or e pa re n ta ls uppo rt re po rte d le ss in vo lv em en t in A RP G . Mo re ov er, stu de n ts w ho pe rc eiv ed str on ge r te ac he r su ppo rt w er e le ss lik ely to be A RP G s. Fin all y, th er e w er e n o as so cia tio n s be tw ee n A RP G an d pe rc eiv ed su ppo rt fro m pe er s an d cla ss m ate s. T he be tw ee n -r eg io n m od el (Mo de l 2) in clu de d re gio n al va ria ble s. In th e 21 Ita lia n re gio n s/c iti es ,in co m e in eq ua lity (Gini in de x) w as po sit iv ely as so cia te d w ith A RP G .T hu s, stu de n ts w ho liv ed in a re gio n /c ity w ith m or e pr on ou n ce d in co m e in eq ua lit ie s ha d hig he r od ds of A RP G . A dd iti on all y, G D P pe r ca pi ta w as n eg ati ve ly re la te d to A RP G .S tu de n ts w ho liv ed in a re gio n /c ity in w hic h G D P pe r ca pi ta w as hig he r w er e le ss lik ely to be A RP G s. A dd iti on all y, in or de r to ve rif y th e po ss ib le diff er en t eff ec ts of pe rc eiv ed so cia l su ppo rt am on g ad ole sc en ts liv in g in diff er en t re gio n s/c iti es ,pa ra lle l an aly se s w er e pe rfo rm ed by ve rif yin gt he va ria bil ity of th es e eff ec ts. A sig n ifi ca n t va ria bil ity w as on ly ob se rv ed fo r pe rc eiv ed te ac he r su ppo rt (X 2 = 36.588, p < 0.05). Fr ontiers in Ps ychology | www .f rontiers in.org 6 Augus t 2017 |V olume 8 |Article 1318Ca n a le e t a l. In c o m e In e q u a lity a n d A d o le sc e n t G a m b lin g TA B L E 2 | Bet ween indi vi dual -and regi onal -l evel vari abl es: Descri pt ive st a tist ic s a nd c orr e la tions. 12 34 56 7 8 M e a n (SD ) M in imu m-ma x imu m IN D IV ID U AL L E V E L (N = 20, 791) 1. Gender (m al e) – 0. 50 (0. 50) 0. 0– 1. 0 2. Fam ily W eal th 0. 04 *** – 2. 01 (0. 66) 1. 0– 3. 0 3. Ot her Fam ily Types 0. 07 *** − 0. 05 *** – 0. 29 (0. 45) 0. 0– 1. 0 4. Per cei ved Fam ily support 0. 12 *** 0. 0 6 ** − 0. 07 *** – 5. 76 (1. 55) 1. 0– 7. 0 5. Per cei ved Peer support − 0. 08 *** 0. 0 5 *** − 0. 05 *** 0. 3 0 *** – 5. 86 (1. 47) 1. 0– 7. 0 6. Per cei ved Teacher support 0. 04 *** − 0. 01 − 0. 04 *** 0. 2 8 *** 0. 123 *** –3 .3 7 (0 .8 1 ) 1 .0 –5 .0 7. Per cei ved Cl assm at e support 0. 13 *** 0. 0 4 *** − 0. 03 *** 0. 2 3 ** 0. 29 *** 0. 2 7 *** –3 .7 8 (0 .8 1 ) 1 .0 –5 .0 8. ARPG 0. 18 *** − 0. 04 ** 0. 06 *** − 0. 05 *** − 0. 05 ** − 0. 04 *** − 0. 02 ** –0 .0 6 (0 .2 3 ) 0 .0 –1 .0 REGI O NA L LEVEL (N =2 1 )# 1 . G IN I – 2. 04 (0. 74) 1. 0– 3. 0 2. GDP per capi ta − 0. 60 ** – 26. 26 (7. 52) 16. 20– 39. 90 3. ARPG 0. 62 ** − 0. 81 *** – 0. 06 (0. 03) 0. 01– 0. 11 *** p < 0 .0 0 1 ;** p < 0 .0 1 ; # T h e n u m be r o f re g io n a lle ve ls to ta ls 21 be c a u s e th e Tr e n ti n o da ta c om pr is e d tw o di ffe re n t ge ogr a ph ic a re a s (i.e ., B ol za n o a n d Tr e n to) . H ow ev er, n on e of th e re gio n al le ve l pr ed ic to rs ex pl ain ed th is va ria bil ity .
DISCUSSION
T he pr im ar y aim of th e pr es en t stu dy w as to ex te n d kn ow le dg e of adole sc ent ga mbli ng re se ar ch by exa mi ni ng th e as soc ia tion be tw ee n str uc tu ra l de te rm in an ts of ad ole sc en t ga m bli n g in a re pr es en ta tiv e sa m pl e of ad ole sc en ts tu de n ts liv in g in Ita ly .T hr ee ma in re sult s emer ged from th e da ta ana ly si s. Fi rst , th e re su lts demonstra ted th at th ere was a Nort h–Sout h gra dient for th e pr ev ale n ce of at-ris k an d pr ob le m ga m bli n g (A RP G )in Ita ly ,w ith hig he r pr ev ale n ce of at A RP G in th e So ut he rn /Is la n ds /C en tra l Re gio n s (1 1% in Sic ily /A br uz zo ) th an in N or th er n Ita ly (e .g ., 2% in V all e d’A os ta ). T his re su lt is pa rti all y co n sis te n t w ith pr ev io us re po rts sh ow in g th at th e pr ev ale n ce of A RP G is hig he r for adole sc ent s livi ng in more di sa dv ant aged re gi ons in Ita ly ( Gori et al., 2015 ). H ow ev er, th e pr es en t stu dy pr ov id es , fo r th e fir st tim e to th e pr es en t au th or s’ kn ow le dg e, de m on str ati on of an as soc ia tion bet ween inc ome inequa lit y and adole sc ent A RP G . Mo re spe cifi ca lly , re gio n al in co m e in eq ua lit ie s (u sin g G IN I va lu es ) w er e po sit iv ely re la te d to A RP G .T hu s, ad ole sc en t stu dents who live in more uneq ual re gions ha ve a hig her pr ob ab ilit y of be in g at-ris k an d pr ob le m ga m ble rs (A RP G s). It is po ss ib le th at la rg er in co m e diff er en ce s m ay in cr ea se ga m bli n g se ve rit y by in cr ea sin g so cia ls ta tu s diff er en ce s, sta tu s in sec ur iti es , co m pe tit io n an d co n ce rn s ab ou t on e’s re la tiv e po sit io n in th e social hierar chy ( Wi lk in so n ,2 00 4; Wi lk in so n an d P ic ke tt, 20 09 ). Th es e co n ce rn s sta rt to be co m e sa lie n t w he n ad ole sc en ts ar e still de ve lo pi n g a co he re n t un de rs ta n din g of so cia l an d ec on om ic hie ra rc hie s an d th eir pl ac e in th em ( Ya te s an d Y ou n iss , 19 99 ; Qui nt ana , 19 99 ). A do le sc en ce is als o a pa rti cu la rly se n sit iv e de ve lo pm en ta lpe rio d ch ar ac te riz ed by a sh ift in th e ty pe of sta tu s th at m att er s fo r ad ole sc en ts, w ith th eir ow n m on ey an d po sit ion w ith in th e pe er gr ou p be gin to ga in gr ea te r im po rta n ce (i.e ., ad ole sc en ts sta rt de ve lo pi n g th eir ow n sta tu s po sit io n s). Ac co rd in g to ris k se n sit iv ity th eo ry (i.e ., Mi sh ra et al. ,2 01 7 ), in m or e un eq ua lr eg io n s, ad ole sc en ts w ho ex pe rie n ce dispa rit ies be tw ee n on e’s pr es en t an d de sir ed ou tc om es w ou ld pr efe r re la tiv ely hig he r ris k opt io n s, su ch as ga m bli n g. T he y m ay be lie ve th at in co n dit io n s of diffi cu lty in sa tis fy in g a pe rc eiv ed n ee d (i.e., money), gre ater risk-taking (e.g., involvement in gam blin g ac tiv iti es ) is a w ay to sa tisf y su ch a n ee d ( We ber et al., 2004; Mi sh ra an d Fid dic k, 20 12 ). A cc or din g to re la tiv e de pr iv ati on th eo rie s ( Crosby , 19 76 ; Wa lk er and Smi th , 20 02 ), for su ch ad ole sc en ts, ga m bli n g ca n be se en as a ju st ic e-se ek in g oc cu pa tio n ( Ca lla n et al. , 20 08 ) be ca us e ga m bli n g m ig ht off er re so ur ce s to pu rs uin g de sir ab le ou tc om es (e .g ., m on ey , pe er sta tu s) th at ad ole scen ts m ig ht feel they m erit bu t are ot herw ise un w illi ng or una ble to re ac h via conv ent iona l me ans (e .g. , ha ving a job) . In fa ct, ga m bli n g is se en as a m ea n s fo r m on eta ry ga in ( De ch ant an d E lle ry , 20 11 ; C an ale et al. , 20 15 a; D ev os et al. , 20 16 ), es pe cia lly if tra dit io n al w ay s of m ak in g m on ey ar e blo ck ed an d/or una va ila ble ( Ta br i et al. , 20 15 ). T he se po te n tia l ex pl an ati on s su ppo rt co n te m po ra ry th eo rie s of po ve rty ,s ug ge sti n g th at w ha t m att er s in affl ue n ts oc ie tie s is th e ca pa cit y to liv e lif e on a pa r wi th ot her s ( Se n, 19 83 ;T owns end, 19 79 ). A dd iti on all y, ad ole sc en ts liv in g in m or e de pr iv ed co n te xt s m ay be m or e pr on e to ga m ble be ca us e th ey be lie ve th at th eir se lf-wort h is enh anc ed vi a ga mbli ng-rela ted wi ns ( Tu rner et al., 2002; Mo ra sc o et al. ,2 00 7 )o r m ayt ur n to ga m bli n g w he nt he yb eli ev e th at ec on om ic m ob ili ty via tra dit io n al av en ue s is un lik ely ( Ta br i et al., 2015 ). W he n th is be lie f oc cu rs ,g am bli n g ca n be use d as a m ea n s to re lie ve th eir re la tiv e de pr iv ati on ex pe rie n ce .Mo re over , an ad dit io n al ex pl an ati on of w hy in co m e in eq ua lit y appe ar s to in cr ea se A RP G m ig ht in vo lv e th e dis ad va n ta ge hy po th es is, wh ere by st re ss ari si ng from livi ng in more unequa l are as le ads in div id ua ls to us e su bs ta n ce s as a co pi n g m ec ha n ism ( Ca ld w ell et al., 2008 ). T he distre ss th at stems from living in uneq ual so cie tie s w he re in div id ua ls ca n fe el an gr y an d re se n tfu l w he n th ey be lie ve th at th ey ha ve le ss th an th ey de se rv e co m pa re d to ot her s (for a re vi ew, see Smi th et al. , 20 12 ), may drive them to ga m ble to co pe w ith n eg ati ve aff ec t or to en ha n ce po si tiv e aff ec t. Fr ontiers in Ps ychology | www .f rontiers in.org 7 Augus t 2017 |V olume 8 |Article 1318Ca n a le e t a l. In c o m e In e q u a lity a n d A d o le sc e n t G a m b lin g TA B L E 3 | O d d s ra tio s (9 5 % C I) fo r re p o rtin g a t-ris k o r p ro b le m g a m b lin gi n re la tio n to in d iv id u a la n d re g io n a lv a ria b le s. E mp ty mo d e l M o d e l 1 M o d e l 2 FI X ED EFFECT In te rc e p t 0 .0 6 (0 .0 5 –0 .0 7 )*** 0. 02 (0. 01– 0. 03) *** 0. 02 (0. 01– 0. 03) *** IN D IV ID U AL L E V E L (N = 20, 791) Males (ref er en ce = fe m a le s) 6. 43 (5. 40– 7. 66) *** 6. 51 (5. 44– 7. 80) *** Other family ty p es (r e fe re nc e = Tw o bi ol ogi c a lor ad op tiv e p ar ents ) 1. 32 (1. 15– 1. 51) *** 1. 33 (1. 16– 1. 53) *** Fam ily wealth med iu m-h ig h (r e fe re nc e = lo w) 0. 84 (0. 76– 0. 93) ** 0. 85 (0. 77– 0. 94) *** Per ceiv ed family su ppor t 0. 87 (0. 84– 0. 91) *** 0. 87 (0. 83– 0. 92) *** Per ceiv ed p eer su ppor t 0. 97 (0. 93– 1. 02) 0. 97 (0. 93– 1. 02) Per ceiv ed teacher su ppor t 0. 85 (0. 78– 0. 92) *** 0. 85 (0. 78– 0. 92) ** Per ceiv ed clas smate sup p ort 0. 94 (0. 86– 1. 02) 0. 94 (0. 85– 1. 03) REGI O NA L LEVEL (N = 21) GD P p er cap ita 0. 95 (0. 93– 0. 98) *** Gini 1. 25 (1. 06– 1. 47) ** RA NDO M EFFECT Va ria n c e comp onents 0. 26 (0. 51) 0. 22 (0. 47) 0. 08 (0. 26) χ 2 (2 0 )= 239. 87 *** χ 2 (2 0 )= 185. 54 *** χ 2 (1 8 )= 66. 40 *** *** p < 0 .0 0 1 ;** p < 0 .0 1 ; # T h e n u m be r o f re g io n a l le ve ls tota ls 21 be c a u s e th e Tr e n ti n o da ta c o m pr is e d tw o di ffe re n t g e o g ra ph ic a re a s (i.e ., B o lz a n o a n d Tr e n to) . Su ch m ot iv ati on s ar e kn ow n to be po sit iv ely as so cia te d w ith pr ob le m ga m bli n g in ad ole sc en ts an d yo un g ad ult s (e .g ., C an ale et al., 2015b; L ambe et al., 2015 ). Adole scents, like adu lts, may en ga ge in po te n tia l ris ky be ha vio rs (e .g ., ga m bli n g an d alc oh ol co n su m pt io n )a s a m ea n s to co pe w ith fe eli n gs of de pr iv ati on an d social dis ad vant age. A cc or din g to th e co n ce pt ua lf ra m ew or k of ha rm fu lg am bli n g ( Ab bo tt et al. , 20 13 ), conte xtu al ma cro-le vel fa ctor s su ch as ga m bli n g oppo rtu n iti es an d m ac ro ec on om ic in dic ato rs ca n he lp in ex pl ain in g th e po te n tia l eff ec t of in co m e in eq ua lit y on A RP G .A s ga m bli n g ve n ue s (in A us tra lia ,N ew Z ea la n d an d th e Un ite d K in gd om ) te n d to be in ar ea s of so cia ld epr iv ati on ( Woh l an d D avis, 2017 ), be in g ex po se d to su ch a ra n ge of ga m bli n g oppo rtu n iti es m ay als o fo ste r pr o-ga m bli n g att itu de s (e .g ., soc ia l appr ov al an d co n do n in g of ga m bli n g) , w hic h in tu rn , co uld incre ase gam bling invo lvem ent am ong ado le scents. Additio na lly , inco m e ineq uality m ay also be as so ciated w it h lo w er go vernm ent spe n din g on pu bli c he alt h se rv ic es , th er eb y aff ec tin g th e ex te n t of ex po su re ad ole sc en ts m ay ha ve ha d to he alt h pr om ot io n ca m pa ig n s fo r re du cin g pr ob le m ga m bli n g. Se co n d, in div id ua ls w ho liv e in a re gio n in w hic h th e G D P pe r ca pi ta is hig he r, ha ve lo w er od ds of be in g A RP G s. T his fin din g su ppo rts n eo -m ate ria lth eo ry ( Lync h et al., 2000 )i n w hic h hig he r av ail ab ilit y of re so ur ce s is as so cia te d w ith be tte r he alt h out come s. It is po ss ib le to ar gu e th at w ea lth y re gio n s ha ve en ou gh re so urc es fo r he alt h se rv ic e pr ov isi on s an d be n efi ts, su ch as ex pe n dit ur e on pu bli c he alt h, w hic h w as be en fo un d to be as so cia te d w ith lo w er le ve ls of pr ob ab le ga m bli n g pr ob le m s in re pr es en ta tiv e sa m ple s of stu de n ts liv in g in n in e E ur ope an co un tri es ( Mo lin ar o et al., 2014 ). B ey on d in co m e an d w ea lth ,d iff er en ce s in pr ev ale n ce ra te s am on g re gio n s m ay also be pa rti all y ex pl ain ed by la rg e societ al events, like natu ral dis aster s. In a stu dy of risk related to natu ral dis aster s, incre ased risk-taking be ha vio r w as obs er ve d am on g dis aster su rvivo rs ( N or ris et al. ,2 00 2; V la ho v et al. ,2 00 4 ) an d pe rc eiv ed th re at-to -li fe in cr ea se s ris k ta kin g ( Ben-Zur and Zeidner, 2009 ). T hir d, th e pr es en t stu dy re po rte d diff er en t re su lts re ga rd in g th e diff er en tia la n d un iq ue im pa ct of su ppo rt so ur ce s on A RP G , th at is, w hic h so ur ce is m or e ab le to re du ce th e od ds fo r ad ole sc en t to be at-ris k an d pr ob le m ati c ga m ble rs . C on sist en t w ith re su lts fro m pr ev io us stu die s ( Ha rd oo n et al. ,2 00 4; R äs än en et al. , 20 16 ; C an ale et al. , 20 17 ), re su lts fro m th e m ain eff ec ts m od els in dic ate d th at ad ole sc en t stu de n ts w ho pe rc eiv ed m or e su ppo rt fro m pa re n ts an d te ac he rs re po rte d le ss in vo lv em en t in A RP G . It po ss ib le th at po si tiv e re la tio n sh ips w ith pa re n ts an d n on -fam ily ad ult m en to rs (e.g., te ac her s) fo ster feeli ng s of sa fe ty in ou t-o f-h om e se tti n gs am on g ad ole sc en ts, an d pe rc eive th e w id er ad ult co m m un ity as be in g su ppo rti ve (e .g ., Brook s et al., 2012 ), w hic h in tu rn appe ar s to ha ve im po rta n t pr ev en tiv e func tions in inh ibi ting ha rmful forms of ga mbli ng. A ddi tio n all y, re su lts did n ot de m on str ate th at so cia l su ppo rt fro m pe er s an d cla ss m ate s ac co un te d fo r A RP G .T he re ar e se ve ra l ob se rv ati ons th at ca n be m ad e re ga rd in g th e ab se n ce of th is eff ec t. Fir st, th e stu dy of th e im po rta n ce of so cia ls uppo rt so ur ce s in dic ate d th at fri en ds an d pa re n ts w er e pe rc eiv ed as eq ua lly su ppo rti ve by 9-to 15 -y ea r-o ld s, bu t fo r th os e ag ed 16 to 18 ye ar s, th e su ppo rt of fri en ds ex ce ed ed th e su ppo rt of pa re n ts (e .g ., Bok hor st et al. , 2010 ). T hu s, it co uld be th at th e pr ot ec tiv e eff ec t of pe er su ppo rt on ga m bli n g be co m es m or e sa lie n t in old er ag e ad ole sc en ts. Consequent ly ,fut ure st udi es sh ould inc lude st udent s from ot her sc ho ol gr ad es . A n ot he r ex pl an ati on m ay be re la te d to th e fa ct th at so cia lm ot iv es (e .g .,g am bli n g to in cr ea se so cia la ffi lia tio n) do n ot ge n er all y pr ed ic tpr ob le m ga m bli n g in ad ole sc en ts an d yo un g pe ople ( St ewa rt and Z ac k, 20 08 ;D ec ha nt and Elle ry ,2 01 1; L ambe et al., 2015 ). Fin all y, co n tra ry to w ha t w as hy po th es iz ed , n o diff er en ce s w er e fo un d in pe rc eiv ed so cia l su ppo rt ac co un tin g fo r th e as so cia tio n be tw ee n in co m e in eq ua lit y an d A RP G .A cc or din g to th e fin din gs , th e de tri m en ta l im pa ct of re gio n al in eq ua lit y on ad ole sc en t ga m bli n g w as th e sa m e fo r ad ole sc en ts pe rc eiv in g diff er en t le ve ls of so cia l su ppo rt. H ow ev er, ot he r ch ar ac te ris tic s of th e so cia l en vir on m en t (n ot co n si de re d in th e cu rr en t stu dy ) m ig ht am pli fy th e im pa ct of in co m e in eq ua lit y, su ch as th e re le va nt di me ns ions of ec onomi c, soc ia l, and cul tur al ca pi ta l th at ha ve be en fo un d to ex pl ain so cia l in eq ua lit y in ado le scent he alt h (e.g., fo od int ake; De Cler cq et al., 2016 ). T he pr es en t stu dy on ly co n si de re d so cia l re la tio n sh ips th at in vo lv ed th e ad ole sc en ts’ im m ed ia te so cia l en vir on m ent (i.e ., th e “m ic ro sy ste m ” of fa m ily m em be rs , pe er gr ou ps, cla ss m ate s, an d te ac he rs ) bu t so cia l re la tio n sh ips ou tsi de this m ic ro sy ste m ac ro ss n eig hb or ho od s, ra cia l gr ou ps, an d so cie tie s (m or e re la te d to sta tu s co m pe tit io n ) m ig ht m od er ate th e Fr ontiers in Ps ychology | www .f rontiers in.org 8 Augus t 2017 |V olume 8 |Article 1318
Ca n a le e t a l. In c o m e In e q u a lity a n d A d o le sc e n t G a m b lin g as so cia tio n be tw ee n in co m e in eq ua lit y an d ga m bli n g ( Putnam, 2000 ). For the se re asons, fu tu re re se ar ch is needed in order to ex pl or e ot he r un co n sid er ed fa cto rs re la te d to in co m e ineq ualitie s. T he pr es en ts tu dy is n ot w ith ou tit s lim ita tio n s. Fir st, th e stu dy ut iliz ed se lf-re po rt da ta le ad in g to w ell -k n ow n bia se s (s uc ha s memory re ca ll bi ase s and soc ia lde si ra bi lit y bi ase s, et c.) .T hu s,t he stu dy de pe n de d upo n ad ole sc en ts’ re po rts of an d in vo lv em en t in ga m bli n g an d re la tio n sh ips (e .g ., fa m ily w ea lth ,s oc ia l su ppo rt). It w ou ld ha ve be en he lpf ul to co rr ob or ate su ch se lf-re po rts w ith ot he r in fo rm an ts su ch as pa re n ts or te ac he rs . Se co n d, th e H B SC -It aly su rv ey did n ot co lle ct ad dit io n al in fo rm ati on on ga m bli n g be ha vio r (e .g ., ga m bli n g ex pe n dit ur e) , n or w as th er e an y in fo rm ati on ab ou t th e ty pe s of ga m bli n g en ga ge d in . B ec au se pr ev io us stu die s ha ve fo un d th at de pr iv ed ar ea s pr es en t m or e ga m bli n g oppo rtu n iti es (e .g ., in th e fo rm of ga m in g m ac hin es ; Living sto ne, 2001 ), fu tu re re se ar ch shou ld aim to ex pl or e th e as so cia tio n be tw ee n ga m bli n g fre qu en cy an d in co m e in eq uality. T hird , a sign ific an t lim it atio n of th e pr es en t stu dy w as th e cr os s-se cti on al de sig n . C on se qu en tly ,i t ca n n ot as su m e ca us ali ty or ru le ou t re ve rs e ca us ali ty . In fa ct , it is als o po ss ib le th at A RP G co uld le ad to lo w er re gio n al we alt h or hig her inc ome inequa lit y. For inst anc e, th e 20 17 re po rt of th e In sti tu te of P oli tic al, E co n om ic an d So cia l St udi es ( E URI SP E S, 20 17 ) re po rte d th at ga m bli n g dis or de r re pr es en ts th e fo ur th le ad in g ca us e of po ve rty in Ita ly .E xa m ining th es e re la tio n sh ips lo n git ud in all y w ou ld pr ov id e a be tte r unde rs ta ndi ng re la ting to th e ca us al role of inc ome ine qua lity in th e de ve lo pm en t of ga m bli n g pr ob le m s am on g ad ole sc en ts. An ot her lim it atio n derivin g fro m the cro ss-se ctio n al n atu re of th e da ta co n ce rn ed th e po te n tia l cu m ula tiv e eff ec t of in eq ua lity over time (e. g. , Mc D on ou gh et al. , 20 10 ). Fu tu re stu die s sh ou ld fo cu s on an aly zin g th e diff er en tia l eff ec t th at a diff er en t ex po su re to in eq ua lit ie s ov er tim e ca n ha ve on ad ole sc en t ga m bli n g. Fo ur th , in ac co rd an ce w ith th e H B SC pr ot oc ol, th e pa rti cipa n ts w er e on ly 15 -y ea r-o ld stu de n ts. Fu tu re stu die s sh ou ld th er efo re in ve sti ga te th e ass oc ia tio n be tw ee n in co me ineq uality and ado le scent gam bling se verity w it h stu dents from ot he r sc ho ol gr ad es . Fin all y, th e re su lts of th e pr es en t stu dy ca n n ot be ge n er ali ze d to 15 -y ea r-o ld stu de n ts in ot he r pa rts of th e w or ld w he re th e so cio -po lit ic al str uc tu re s m ay be ve ry diff er en t. D es pi te th es e lim ita tio n s, to th e be st of th e au th or s’ kn ow le dg e, th e pr es en t stu dy is th e fir st to in ve sti ga te th e eff ec ts of in co m e in eq ua lit y on A RP G in a la rg e sa m ple re pr es en ta tiv e of th e Ita lia n hig h sc ho ol po pu la tio n .I n pa rti cu lar , th e fin din gs giv e su ppo rt to th e id ea th at ad ole sc en ts w ho liv e in m or e un eq ua l (a n d po or ) re gio n s sh ow hig he r ga m bli n g-re la te d ha rm s. Fo r th is re as on , po lic y ac tio n s ar e n ee de d to redistribute we alt h and cre ate more eg alit arian societie s for re du cin g ad ole sc en t A RP G . C on se qu en tly , po lic y ac tio n s th at co n ce rn lim iti n g ga m bli n g n ee d to su ppo rt ra isi n g ta xe s on ga m bli n g, es pe cia lly in a lo w ga m bli n g ta x co un try lik e Ita ly .F or ex am pl e, Ita ly im po se d ta x ra te s on m ac hin es ou tsi de ca sin os up to fo ur tim es lo w er th an th os e im po se d by A us tri a an d D en m ar k (u p to 13 % in Ita ly co m pa re d to an av er ag e 55 % in D en m ar k, an d up to 50 % in A us tri a [i.e ., ta xa tio n of ga m bli n g se rv ic es as a pe rc en ta ge of n et re ve n ue ] ( Sf etc u, 20 16 ). Ot her po lic y re co m m en da tio n s to po lic ym ak er s co n ce rn in g ad ole sc ent pr ob le m ga m bli n g co uld in clu de : (i) pr ov id in g re gio n s w ith m or e fu n din g fo r im pl em en tin g pr ev en tio n pr og ra m s at sc ho ol le ve l; (ii ) lim iti n g ac ce ss to ga m bli n g oppo rtu n iti es (e .g ., by im po sin g str ic te r pe n alt ie s fo r ga m bli n g ope ra to rs w ho all ow m in or s to ga m ble ill eg all y) ,a n d (ii i) in cr ea sin g pu bli c aw ar ene ss (e .g ., ed uc ati n g pa re n ts, te ac he rs , an d sc ho ol ad m in ist ra tor s) th at ad ole sc en ts ar e n ot im m un e to ga m bli n g-re la te d ha rm s. In ad dit io n to re dis tri bu tiv e fis ca l po lic ie s aim ed at pr om ot ing inco m e eq uality at the re gio nal le vel, ou r finding s underlin et he n ee d to im pl em en t pr ev en tio n pr og ra m s sta rti n g fro m m or e un eq ua l re gio n s, w he re pr ev en tio n eff or ts ar e m os t n ee de d. E du ca tio n al in te rv en tio n s sh ou ld also te ac h ad ole sc en ts to re cognize th e attitude s and be ha vior s th at dis criminate ,a nd re ac h ou tt o ad ole sc en ts in un eq ua la re as fo r pr o-re spo n sib le ga m bling po lic y. W ith re ga rd to so cia ls uppo rt, th e pr es en t stu dy su gg es ts th at pr ev en tio n eff or ts m ay be n efi t fro m be in g pa rti cu la rly m in df ul of th os e ad ole sc en ts w ho la ck so cia l su ppo rt fro m pa re n ts an d te ac he rs . A do le sc en ts w ho pe rc eiv ed th em se lv es as re ce iv in g le ss pa re n ta l su pe rv isi on ar e m or e lik ely to be at-ris k an d pr ob le m ga m ble rs or fre qu en t ga m ble rs (e .g ., Ha rd oo n et al. , 20 04 ; C an ale et al. , 20 16 b ). T hu s, pr ev en tio n pr og ra m s co uld fo cu s on te ac hin g pa re n ts to de ve lo p tru sti n g (a n d n on -in tru siv e) pa re n t– ch ild re la tio n sh ips th at fo ste r ho n es t se lf-dis closure. In conclusion, ac cording to th e adole scent ris k be ha vio r m od el in co rpo ra tin g yo ut h ga m bli n g ris k fa cto rs ( Dickson et al., 2002 a m od el ad apt ed fro m Je ss or , 19 98 ), th e pr es en t stu dy pr ov id es an ex am ple of ho w po ss ib le ris k an d pr ot ec tiv e fa cto rs ope ra te in an d ac ro ss a n um be r of do m ain s (e .g ., so cia l en vir on m en t an d pe rc eiv ed en vir on m en t). In co n clu sio n , th e pr es en t stu dy fo r th e fir st tim e (to ou r kn ow led ge) w as ab le to sho w th at in co m e in eq ual ity m ay ha ve a co n te xt ua l in flu en ce on A RP G . A s th is is th e fir st de m on str ati on of th is as so cia tio n , su bs ta n tia l re pl ic ati oni s required.
