not contradict the notion that younger and older people have gambling problems.

Gender

Etiological studies of pathological and problem gambling have generally focused on men from Gamblers Anonymous (GA) and men from the Veterans Administration hospital system (Mark and Lesieur, 1992). Consequently, men in the general population have been underrepresented in studies, and women are critically underrepresented as well. Many early studies that did include women were based on small numbers of women or relied on anecdotal reports of women in Gamblers Anonymous (Lesieur and Blume, 1991). Yet many studies inappropriately generalize findings about men to women (Mark and Lesieur, 1992). Although men typically begin gambling earlier than women, women appear to experience the onset of problem gambling earlier in the course of their gambling disorder than men (Mark and Lesieur, 1992), but controlled studies are rare (Custer, 1982; Livingston, 1974; Custer and Milt, 1985).

The American Psychiatric Association reports in three editions of the Diagnostic and Statistical Manual of Mental Disorders (DSM) that the rate of pathological gambling is twice as high among men than among women (American Psychiatric Association, 1987, 1994, 1980). Although no epidemiological evidence substantiated this finding at the time the manuals were first published, some studies have found rates that high (e.g., Cunningham-Williams et al., 1998; Volberg and Abbott, 1997; Volberg, 1994), and other studies consistently show that men gamble more and have higher rates of pathological gambling than do women, even if not at twice the rate (e.g., Lesieur et al., 1991).

Ethnicity and Socioeconomic Status

Most studies of pathological and problem gambling have focused on white male gamblers. Consequently, there exists little population-based literature or data pertaining to women or nonwhite ethnic and cultural groups (Mark and Lesieur, 1992; Volberg, 1994). Specifically, studies among black, Hispanic, Asian,



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