The WAGER, Vol. 17(10) – Up close: Gambling and the telescoping effect


Researchers have observed that women tend to start gambling later in life but progress to gambling-related problems more quickly compared to men (Nelson et al., 2006). Piazza, Vrbka and Yeager (1989) refer to this phenomenon as the telescoping effect. Although the causes of telescoping remain unclear, previous studies investigating gender differences in the development of addiction suggest that anxiety disorders might relate to telescoping (Ibanez, 2003; Kushner, 2011); people who have a co-morbid anxiety tend to progress more quickly from recreational to hazardous drinking. This week’s WAGER reviews a study that tested whether co-morbid anxiety also helps explain gender differences in the progression of pathological gambling  (Grant, 2012).


  • Researchers recruited 71 individuals seeking treatment for pathological gambling (PG) from a clinical research trial:
  • The study excluded people with lifetime psychotic or bipolar disorder and people with current (past 12 months) substance abuse or dependence.
  • The study compared 34 women (51.6 years old [SD=10.6] years) with 37 men (44.2 years old [SD=12.7] years).
  • The researchers recorded the following variables through semi-structured clinical interviews:
  • Gambling behaviors, measured by the Structured Clinical Interview for Pathological Gambling (Grant et al., 2004);
  • Age of gambling initiation;
  • Time from initiation to meeting criteria for PG;
  • Current and lifetime Axis-1 psychiatric disorders (First, 1995); and,
  • Demographic features
  • The researchers used the Cox proportional hazards regression test to examine gender differences in the time to developing PG symptoms, controlling for demographic variables, type of gambling, and psychiatric comorbidity.


  • Women had a higher mean age at gambling initiation (Mean = 31.3 years, SD = 13.0) compared with men (Mean = 22.4 years, SD = 7.9); t(69)=2.668, p < .001.
  • There were no significant differences in rates of psychiatric comorbidity in men and women.
  • Figure 1 shows that women had a significantly shorter time from initiation of gambling to meeting the criteria for PG (8.33 years [SD= 8.7] compared with 11.97 years [SD= 9.1];  log-rank chi-square (1) = 3.92p < .05), controlling for demographic variables, type of gambling, and psychiatric comorbidity.
  • These results were in the absence of certain lifetime anxiety, impulse control, affective, alcohol use and substance use disorders.

Figure 1.  Time from Initiation of Gambling to Problem Gambling
WAGER 18(1) Image

Note: adapted from data presented in Grant et al. (2012)


  • Researchers derived measures of gambling activity from retrospective self-report and these might not accurately reflect actual behaviors, feelings, or thoughts.  
  • Researchers excluded people with past-year substance disorders, lifetime psychotic disorders and lifetime bipolar disorders, thus diminishing the generalizability of the findings—particularly given that PG is highly comorbid with other substance use disorders (Kessler et al., 2008).
  • The sample may be potentially biased because it is made up of treatment seekers. People who seek treatment represent only a small slice of those with PG, and may not be representative of the overall PG population.


Consistent with previous research, compared with men, women had a significantly shorter time from their initiation of gambling behavior to meeting the criteria for pathological gambling. Furthermore, this pattern was evident even after controlling for the potential confounding effects of major lifetime psychiatric comorbidity. The persistence of the telescoping effect suggests that certain characteristics, apart from comorbidity, might better account for the temporal course of problem gambling behavior. Women might experience the telescoping effect because of gender-specific social or biological pressures or because they start gambling later (Nelson et al., 2006). Gender is one small point in a possible constellation of psychosocial factors that may affect the trajectory of PG. Future research could provide greater clinical focus on the gender differences of gambling behavior, while controlling for a greater range of psychiatric and demographic variables.

-Kat Belkin

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First, M., Spitzer, RL, Gibbon, M, & Williams JBW. (1995). Structured clinical interview for DSM-IV-patient edition (SCID-I/P, Version 2.0). New York: Biometrics Research Department, New York State Psychiatric Institute.

Grant, J., Odlaugh, BL, & Mooney, ME. (2012). Telescoping phenomenon in pathological gambling: Association with gender and comorbidities. Journal of Nervous Mental Disorders, 200, 996-998.

Ibanez, A., Blanco, C, Moreryra, P, & Saiz-Ruiz J. (2003). Gender differences in pathological gambling. Journal of Clinical Psychiatry, 64, 295-301.

Kessler, R. C., Hwang, I., LaBrie, R., Petukhova, M., Sampson, N. A., Winters, K. C., et al. (2008). DSM-IV Pathological Gambling in the National Comorbidity Survey Replication. Psychological Medicine.

Kushner, M., Maurer, E, Menary, K, & Thuras, P. (2011). Vulnerability to the rapid ("telescoped") development of alcohol dependence in individuals with anxiety disorder. Journal for the Studies of Alcohol and Drugs, 72, 1019-1027.

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