Impulsivity trajectories and gambling in adolescence among urban male youth

Youth problem gambling is widespread and associated with a broad range of high-risk behaviors such as delinquency and substance use [1], and thus is a public health concern. Research has focused on examining the developmental antecedents (such as impulsivity, depression, and anxiety) of gambling in late adolescence/early adulthood [2]. Impulsivity has received the most attention [3–6]. Many scholars have taken note on the multifaceted nature of impulsivity as well as the heterogeneity in its manifestation [7–10]. Despite the difficulty in defining a single trait of impulsivity, two elements must be present, i.e. an impulse or an urge to act and a lack of inhibition or restrain of that urge [11]. Thus, impulsivity is defined as a tendency towards making rush decisions without carefully considering potential negative consequences [12]). Despite evidence that impulsivity is not stable during adolescence [13–15], most studies evaluating the impulsivity-gambling association have only measured impulsivity at a single point-in-time and gambling either concurrently or at a later time-point. Longitudinal links between the development of impulsivity and late adolescent gambling have not been adequately explored. Most studies were based on samples of French Canadian, predominantly Caucasian adolescents [3,5], leaving low socio-economic status (SES), minority, urban youth understudied. Such oversight is problematic as this population is disproportionately more likely to exhibit both higher levels of impulsivity [16] and problem gambling (e.g. [17–22]). Characterized by an imbalance between a reasonably-developed reward and punishment processing system and an underdevelopment of impulse control [23], adolescents are vulnerable to risk-taking behaviors including problem gambling [24]. Such vulnerability, together with easy access of gambling opportunities, has resulted in most North American adolescents engaging in gambling activities [25]. The prevalence of gambling problems among adolescents (3–8%) is significantly higher than that among adults (1–3%; [25]). Several theories make the impulsivity-gambling association plausible. Jacobs' general theory of addictions [26] proposes that highly stimulating activities, such as gambling, are often pursued as means to relieve stress. Individuals with a greater propensity for risk taking and sensation seeking, both important components of impulsivity [27], tend to be more exposed to excessive chronic stress resulted from a hypo-aroused psychological state [28], and, in turn, are more likely to engage in addictive behavior such as gambling. Jessor and Jessor's problem behavior theory [29] posits problem behaviors, such as gambling, substance use, and criminal offending often co-occur in a problem behavior syndrome, and individuals' likelihood of engaging in such behaviors is strongly associated with their levels of impulsivity. Research examining the development of impulsivity during adolescence, shows a general downward trend (e.g. [13]) as well as interindividual heterogeneity in that trend [30,31]. To date, Betancourt et al. [30] is the only study that related developmental heterogeneity in impulsivity to gambling (although not as the main focus of the study): the authors found three longitudinal profiles in impulsivity among a sample of predominately middle-class Caucasian youth followed from age 10 to 15: low (6%), moderate (57%), and high (37%) trajectories. Youth in the high impulsivity trajectory were twice as likely to engage in gambling by age 15, compared to those in the moderate and low impulsivity groups. While Betancourt and colleagues' findings [30] are informative, impulsivity and gambling were measured during the same time periods, blurring the directionality of the association. The authors only studied any involvement in gambling without distinguishing problem gamblers from those who did not meet criteria for problem gambling. Not making such a distinction hinders the ability to study what distinguishes gambling problems from any gambling which is very relevant from an etiological as well as a prevention perspective. Based upon theories that make the impulsivity-gambling association plausible [26–29], the present study aims to explore the association between impulsivity development in early adolescence and gambling in late adolescence using growth modeling. First, we examine whether the starting point and change of impulsivity during early adolescence (ages 11– 15) are related to subsequent gambling among a sample of high-risk urban males. Second, we explore whether there are distinct patterns (i.e. population heterogeneity) of impulsivity development among the study sample. Third, we further investigate whether these distinct trajectories are differentially related to subsequent gambling. We explore whether different trajectories are associated with engaging in any gambling, meeting criteria for at-risk gambling or problem gambling, and meeting criteria for problem gambling in late adolescence.