Problematic Alcohol Use and Problem Gambling: Associations to Structural and Functional aspects of Social Ties in a Finnish Population Sample

Open access


AIMS – This study aims to explore associations between structural and functional aspects of social networks and relationships (here labelled social ties) among individuals exhibiting problematic alcohol use and problem gambling, respectively.

MATERIAL & METHODS – Data was collected in the 2011 Western Finland Mental Health Survey, a postal questionnaire survey applying a stratified random sampling approach. The survey response rate was 46.2% (n = 4624, age range 15–80 years). Problem behaviours were assessed using the CAGE and Lie/Bet tools. Logistic regression analyses were performed, with problematic alcohol use and problem gambling as dependent variables. Demographic variables, structural social tie factors (marital status, frequency of social contacts, engagement in association activities) and functional social tie factors (experienced loneliness, social support, neighbourhood trust, general trust) constituted explanatory variables.

RESULTS – In this representative population sample, only one structural social tie variable, marital status, proved to be significantly associated with one of the outcomes (problematic alcohol use). Identical functional social tie variables were associated with both problematic alcohol use and problem gambling: individuals exhibiting the problem behaviours experienced higher levels of experienced loneliness and low levels of neighbourhood trust. Identified interaction effects with demographic factors highlight the complexity of links.

CONCLUSIONS – Functional aspects of individual-level social ties appear to be more relevant when studying problematic alcohol use or problem gambling, similarly to other forms of mental health problems. The role of social ties as preventive or risk factors for problem behaviour development, as a part of problem behaviour maintenance or as a cessation and a recovery resource should be further explored, considering also interactions with demographic variables.

If the inline PDF is not rendering correctly, you can download the PDF file here.

  • Ahlström S. Bloomfield K. & Knibbe R. (2001). Gender differences in drinking patterns in nine European countries: Descriptive findings. Substance Abuse 22(1) 69–85.

  • American Psychiatric Association (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington DC: American Psychiatric Association.

  • Aromaa E. (2011). Attitudes towards people with mental disorders in a general population in Finland. Research 69. Helsinki: National Institute for Health and Welfare (THL).

  • Babbie E. (1990). Survey research methods. Belmont California: Wadsworth.

  • Blaszczynski A. & Nower L. (2002). A pathways model of problem and pathological gambling. Addiction 97(5) 487–499.

  • Brevik J. I. & Dalgard O. (1996). The Health Profile Inventory. Oslo.

  • Bühringer G. Kräplin A. & Behrendt S. (2012). Universal characteristics and consequences of the addiction syndrome. In H. J. Shaffer (Ed) APA Addiction Syndrome Handbook: Vol. 1 Foundations Influences and Expressions of Addiction (pp. –). Washington DC: American Psychological Association.

  • Castrén S. Basnet S. Salonen A. H. Pankakoski M. Ronkainen J-E. Alho H. & Lahti T. (2013). Factors associated with disordered gambling in Finland. Substance Abuse Treatment Prevention and Policy 8(1).

  • Cohen S. & Wills T. A. (1985). Stress social support and the buffering hypothesis. Psychological Bulletin 98 310–357.

  • De Silva M. J. McKenzie K. Harpham T. & Huttly S. R. A. (2005). Social capital and mental illness: A systematic review. Journal of Epidemiology and Community Health; 59(8) 619–627.

  • Dillman D. A. (2000). Mail and Internet surveys: The total design method (2nd ed.). New York: Wiley.

  • Ekholm O. Eiberg S. Davidsen M. Holst M. Larsen C. V. L. & Juel K. (2014). The prevalence of problem gambling in Denmark in 2005 and 2010: A sociodemographic and socioeconomic characterization. Journal of Gambling Studies 30(1) 1–10.

  • Ewing J. A. (1984). Detecting alcoholism. The CAGE questionnaire. Journal of the American Medical Association; 252(14) 1905–1907.

  • Ewing J. A. (2000). CAGE Questionnaire. In Task force for the handbook of psychiatric measures (Ed.) (pp. –). Washington DC: American Psychiatric Association.

  • Granfield R. & Cloud W. (2001). Social context and “natural recovery”: The role of social capital in the resolution of drug-associated problems. Substance Use and Misuse 36(11) 1543–1570.

  • Grant J. E. Brewer J. A. & Potenza M. N. (2006). The neurobiology of substance and behavioral addictions. CNS Spectrums 11(12) 924–930.

  • Grant J. E. & Chamberlain S. R. (2015). Gambling disorder and its relationship with substance use disorders: Implications for nosological revisions and treatment. The American Journal on Addictions 24(2) 126–131.

  • Götestam K. G. Johansson A. Wenzel H. G. & Simonsen I-E. (2004). Validation of the Lie/Bet screen for pathological gambling in two normal population data sets. Psychological Reports 95(3) 1009–1013.

  • Herberts C. Aromaa E. Björkqvist K. Forsman A. Herberts K. Nordmyr J. Nyqvist F. Salokangas R. Tuulari J. & Wahlbeck K. (2012). Western Finland Mental Health Survey 2011: Survey methods. Report 39/2012. Helsinki: National Institute for Health and Welfare (THL).

  • Hing N. Holdsworth L. Tiyce M. & Breen H. (2014). Stigma and problem gambling: Current knowledge and future research directions. International Gambling Studies 14(1) 64–81.

  • Holdsworth L. Hin N. & Breen H. (2012). Exploring women’s problem gambling: A review of the literature. International Gambling Studies 12(2) 199–213.

  • Horch J. D. & Hodgins D. C. (2008) Public stigma of disordered gambling: Social distance dangerousness and familiarity. Journal of Social and Clinical Psychology 27(5) 505–528.

  • Huhtanen P. Miekkala M. Mustonen H. & Mäkelä P. (2011). Suomalaisten alkoholinkäyttötavat 1968–2008: Juomatapatutkimusten tuloksia. [Results from the Finnish Drinking Habits Surveys 1968–2008]. Report 26/2011. Helsinki: National Institute for Health and Welfare (THL).

  • Hunter-Reel D. Witkiewitz K. & Zweben A. (2012). Does session attendance by a supportive significant other predict outcomes in individual treatment for alcohol use disorders? Alcoholism: Clinical and Experimental Research 36(7) 1237–1243.

  • Ingle P. J. Marotta J. McMillan G. & Wisdom J. P. (2008). Significant others and gambling treatment outcomes. Journal of Gambling Studies 24(3) 381–392.

  • Johnson E. E. Hamer R. M. & Nora R. M. (1998). The Lie/Bet Questionnaire for screening pathological gamblers: A follow-up study. Psychological Reports83(3) 1219–1224.

  • Johnson E. E. Hamer R. Nora R. M. Tan B. Eisenstein N. & Engelhart C. (1997). The Lie/Bet Questionnaire for screening pathological gamblers. Psychological Reports80(1) 83–88.

  • Lindström M. (2005). Social capital the miniaturization of community and high school alcohol consumption: A population-based study. Alcohol & Alcoholism 40(6) 556–562.

  • Marmot M. G. (2003). Understanding social inequalities in health. Perspectives in Biology and Medicine 46(3 Suppl) 9–23.

  • McCrady B. S. (2004). To have but one true friend: Implications for practice of research on alcohol use disorders and social networks. Psychology of Addictive Behaviors 18(2) 113–121.

  • McQuade A. & Gill P. (2012). The role of loneliness and self-control in predicting problem gambling behaviour. Gambling Research 24(1) 18–30.

  • Meltzer H. (2003). Development of a common instrument for mental health. In A. Nosikov & C. Gudex (Eds) EUROHIS: Developing common instruments for health surveys (pp. –). Amsterdam: IOS Press.

  • Ministry of Social Affairs and Health (2006). Alcohol issues in Finland after accession to the EU. Consumption harm and policy framework 1990–2005. Reports of the Ministry of Social Affairs and Health 2006:21. Helsinki: Ministry of Social Affairs and Health.

  • Mowbray O. Quinn A. & Cranford J. A. (2014). Social networks and alcohol use disorders: Findings from a nationally representative sample. The American Journal of Drug and Alcohol Abuse 40(3) 181–186.

  • National Advisory Board on Research Ethics (2009). Ethical principles of research in the humanities and social and behavioural sciences and proposals for ethical review. Helsinki: National Advisory Board on Research Ethics.

  • Nyqvist F. Finnäs F. Jakobsson G. & Koskinen S. (2008). The effect of social capital on health: The case of two language groups in Finland. Health & Place 14(2) 347–360.

  • Pampel F. C. (2000). Logistic regression: A primer. Thousand Oaks: SAGE.

  • Parcesepe A. P. & Cabassa L. J. (2013). Public stigma of mental illness in the United States: A systematic literature review. Administration and Policy in Mental Health and Mental Health Services Research 40(5) 384–399.

  • Rash C. J. Weinstock J. & Van Patten R. (2016). A review of gambling disorder and substance use disorders. Substance Abuse and Rehabilitation 7 3–13.

  • Robbins T. W. & Clark L. (2015). Behavioral addictions. Current Opinion in Neurobiology 30 66–72.

  • Salonen A. & Raisamo S. (2015). Suomalaisten rahapelaaminen 2015. Rahapelaaminen rahapeliongelmat ja rahapelaamiseen liittyvät asenteet ja mielipiteet 15–74-vuotiailla. [Finnish gambling 2015. Gambling gambling problems and attitudes and opinions on gambling among Finns aged 15–74.]. Report 16/2015. Helsinki: National Institute for Health and Welfare (THL).

  • Schomerus G. Lucht M. Holzinger A. Matschinger H. Carta M. G. & Angermeyer M. C. (2011). The stigma of alcohol dependence compared with other mental disorders: A review of population studies. Alcohol and Alcoholism 46(2) 105–112.

  • Schutt R. K. (1999). Investigating the social world: The process and practice of research (2nd ed.). Thousand Oaks California: Pine Forge Press.

  • Sundqvist K. & Wennberg P. (2015). Risk gambling and personality: Results from a representative Swedish Sample. Journal of Gambling Studies 31 1287–1295

  • Thoits P. (2011). Mechanisms linking social ties and support to physical and mental health. Journal of Health and Social Behavior 52(2) 145–161.

  • Tuchman E. (2010). Women and addiction: The importance of gender issues in substance abuse research. Journal of Addictive Diseases 29(2) 127–138.

  • West R. & European Monitoring Centre for Drugs and Drug Addiction (2013). Models of addiction. EMCDDA Insights Series No. 14. Luxembourg: Publications Office of the European Union.

  • West R. & Brown J. (2013). Theory of addiction (2nd ed.). Oxford: Wiley Blackwell.

  • Williams R. J. Volberg R. A. & Stevens R. M. G. (2012). The population prevalence of problem gambling: Methodological influences standardized rates jurisdictional differences and worldwide trends. Guelph: Ontario Problem Gambling Research Centre.

  • White W. L. & Cloud W. (2008). Recovery Capital: A primer for addictions professionals. Counselor 9(5) 22–27.

  • World Medical Association (2000). WMA declaration of Helsinki: Ethical principles for medical research involving human subjects. Retrieved from

  • Yau Y. H. C. & Potenza M. N. (2015). Gambling disorder and other behavioral addictions: Recognition and treatment. Harvard Review of Psychiatry23(2) 134–146.

Journal information
Impact Factor

IMPACT FACTOR 2017: 0.683
5-year IMPACT FACTOR: 0.752

CiteScore 2018: 0.64

SCImago Journal Rank (SJR) 2018: 0.313
Source Normalized Impact per Paper (SNIP) 2018: 0.456

All Time Past Year Past 30 Days
Abstract Views 0 0 0
Full Text Views 151 82 1
PDF Downloads 67 36 0