title: Gamblers seeking treatment: Who does and who doesn't?
abstract: OBJECTIVE
  As only a minority of pathological gamblers (PGr) presents for treatment, further knowledge about help-seeking behavior is required in order to enhance treatment utilization. The present study investigated factors associated with treatment participation in gamblers in Germany. As subclinical pathological gamblers (SPGr, fulfilling one to four DSM-IV-criteria) are target of early intervention due to high risk of transition to pathological gambling, they were subject of special interest.
  
  
  METHODS
  The study analyzed data from a general population survey (n = 234, SPGr: n = 198, PGr: n = 36) and a treatment study (n = 329, SPGr: n = 22, PGr: n = 307). A two-step weighting procedure was applied to ensure comparability of samples. Investigated factors included socio-demographic variables, gambling behavior, symptoms of pathological gambling and substance use.
  
  
  RESULTS
  In PGr, regular employment and non-German nationality were positively associated with being in treatment while gambling on the Internet and gaming machines and fulfilling more DSM-IV-criteria lowered the odds. In SPGr, treatment attendance was negatively associated with married status and alcohol consumption and positively associated with older age, higher stakes, more fulfilled DSM-IV criteria and regular smoking.
  
  
  CONCLUSIONS
  In accordance to expectations more severe gambling problems and higher problem awareness and/or external pressure might facilitate treatment entry. There are groups with lower chances of being in treatment: women, ethnic minorities, and SPGr. We propose target group specific offers, use of Internet-based methods as possible adaptions and/or extensions of treatment offers that could enhance treatment attendance.
authors.affiliation: IFT Institut fűr Therapieforschung, Munich, Germany.
authors.forename: Barbara
authors.initials: B
authors.lastname: Braun
authors.affiliation: Institut fűr Psychologie, Universität Hildesheim, Germany.
authors.forename: Monika
authors.initials: M
authors.lastname: Ludwig
authors.affiliation: IFT Institut fűr Therapieforschung, Munich, Germany.
authors.forename: Pawel
authors.initials: P
authors.lastname: Sleczka
authors.affiliation: IFT Institut fűr Therapieforschung, Munich, Germany ; Addiction Research Unit, Institut fűr Klinische Psychologie und Psychotherapie, Technische Universität Dresden, Germany.
authors.forename: Gerhard
authors.initials: G
authors.lastname: Bühringer
authors.affiliation: IFT Institut fűr Therapieforschung, Munich, Germany ; Centre for Social Research on Alcohol and Drugs (SoRAD), Stockholm University, Sweden.
authors.forename: Ludwig
authors.initials: L
authors.lastname: Kraus
keywords: addiction care; pathological gamblers; predictors; subclinical pathological gamblers; treatment-seeking