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Impulsivity in kindergarten may predict gambling behavior in sixth grade
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CHICAGO—Children whose teachers rated them as more impulsive in kindergarten appear more likely to begin gambling behaviors by the sixth grade, according to a report in the March issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.



Although gambling has become an increasingly common activity among U.S. adults and teens, public health risks remain, the authors write as background information in the article. "Problematic gambling in adults is associated with substance use, depression and suicide, psychopathology, poor general health and a multitude of family, legal and criminal problems," the authors wrote. "Most disconcerting is that young people seem more vulnerable than adults to gambling-related morbidity [illness] and suicidality. Data suggest that in most cases, youthful recreational gambling predates pathological gambling in adulthood."

Linda S. Pagani, Ph.D., of Sainte-Justine University Hospital Research Center and the Université de Montréal, Canada, and colleagues studied 163 children who were in kindergarten in 1999 (average age 5.5). At the beginning of the school year, teachers were asked to complete a questionnaire rating their students' inattentiveness, distractibility and hyperactivity on a scale from one to nine (with higher values indicating a higher degree of impulsiveness). After six years, when the children were an average of 11.5 years old, they were interviewed by phone and asked whether and how often they played cards or bingo, bought lottery tickets, played video games or video poker for money or placed bets at sports venues or with friends.

After considering other behaviors that may be associated with youth gambling, including parental gambling, a one-unit increase on the kindergarten impulsivity scale corresponded to a 25-percent increase in a child's involvement in gambling in sixth grade.

"Our results suggest that behavioral features such as inattentiveness, distractibility and hyperactivity at school entry represent a vulnerability factor for precocious risk-oriented behavior like gambling in sixth grade," the authors write. "It is very plausible that these childhood characteristics snowball into cumulative risks for youngsters who do not eventually outgrow the distractibility and inattentiveness from early childhood and become involved in gambling as a typical pastime for many youth. Most importantly, our observations suggest a developmentally continuous effect of impulsivity that places individuals on a life course trajectory toward gambling involvement in adolescence and emerging adulthood."

Brain mechanisms underlying both impulsivity and problem gambling may include reward pathways and areas associated with decision making and self-regulation, the authors note. Training in self-control and executive functions before first grade may show positive results, they conclude.
(Arch Pediatr Adoles Med. 2009;163[3]:238-243. Editor's Note: This work was funded by Canada's Social Science and Humanities Research Council Standard Research Grants Program. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

For more information, contact JAMA/Archives media relations at 312/464-JAMA (5262) or e-mail mediarelations{at} .

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