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Slutske WS, Richmond-Rakerd LS, Piasecki TM, Ramrakha S, Poulton R, Moffitt TE, Caspi A. Disordered gambling in a longitudinal birth cohort: from childhood precursors to adult life outcomes. Psychol Med 2023; 53:5800-5808. [PMID: 36254750 PMCID: PMC10482703 DOI: 10.1017/s0033291722003051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 09/06/2022] [Accepted: 09/09/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Despite its introduction into the diagnostic nomenclature over four decades ago, there remain large knowledge gaps about disordered gambling. The primary aims of the present study were to document the long-term course, childhood precursors, and adult life outcomes associated with disordered gambling. METHODS Participants enrolled in the population-representative Dunedin Study were prospectively followed from birth through age 45. Disordered gambling was assessed six times from age 18; composite measures of childhood social class, general intelligence, and low self-control were based on assessments obtained from birth through age 15; adult socioeconomic, financial, and legal outcomes were obtained through age 45. Lifetime disordered gambling was predicted from the three childhood precursors and the adult outcomes were predicted from lifetime disordered gambling. RESULTS Past-year disordered gambling usually occurred at only a single time point and recurrence was relatively uncommon. Lower childhood social class, general intelligence, and self-control significantly predicted lifetime disordered gambling in adulthood. In turn, lifetime disordered gambling in adulthood significantly predicted occupational, educational, and financial problems in adulthood (ds = 0.23-0.41). These associations were markedly reduced and sometimes rendered nonsignificant after adjusting for childhood precursors (ds = 0.04-0.32). CONCLUSIONS Socioeconomic, financial, and legal outcomes in adulthood are not merely consequences of disordered gambling, but also are predicted from childhood precursors. Deflecting the trajectories of young people at risk for developing disordered gambling may help to ameliorate not just the development of later disordered gambling, but also other associated adverse outcomes.
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Affiliation(s)
- Wendy S. Slutske
- Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | | | - Thomas M. Piasecki
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Sandhya Ramrakha
- Department of Psychology, University of Otago, Dunedin, New Zealand
| | - Richie Poulton
- Department of Psychology, University of Otago, Dunedin, New Zealand
| | - Terrie E. Moffitt
- Department of Psychology and Neuroscience, Duke University, Durham, North Carolina, USA
| | - Avshalom Caspi
- Department of Psychology and Neuroscience, Duke University, Durham, North Carolina, USA
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Bickl AM, Schwarzkopf L, Loy JK, Grüne B, Braun-Michl B, Sleczka P, Örnberg JC, Kraus L. Changes in gambling behaviour and related problems in clients seeking help in outpatient addiction care: Results from a 36-month follow-up study in Bavaria. J Behav Addict 2021; 10:690-700. [PMID: 34319902 PMCID: PMC8997214 DOI: 10.1556/2006.2021.00043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 06/09/2021] [Accepted: 06/13/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND AND AIM Evidence on the course of gambling disorder (GD) in clients seeking help from outpatient addiction care facilities is sparse. To close this knowledge gap, this longitudinal one-armed cohort study portrays the development of GD in help-seeking clients over a 3-year timeframe. METHODS We investigated changes in severity of GD as well as in gambling frequency and intensity in 145 gamblers in outpatient treatment in Bavaria using generalized estimation equations (GEEs). To investigate potentially different trajectories between study participants with and without migration background (MB), additional analyses were applied with time*migration interaction. All analyses were adjusted for age, gender, education, electronic gambling machine (EGM) gambling, MB, GD, related help sought before and treatment status. RESULTS Within the entire study population, improvements in severity of GD (reduction of 39.2%), gambling intensity (reduction of 75.6%) and gambling frequency (reduction of 77.0%) were observed between baseline and 36 months of follow-up. The declines were most pronounced between baseline and follow-up 1 and stabilized thereafter. Participants with MB improved consistently less than participants without MB. DISCUSSION AND CONCLUSION Our study suggests that severity of GD and gambling patterns improve in the context of outpatient treatment. The beneficial results furthermore persist for 36 months after treatment termination. As clients with MB seem to profit less than clients without MB, improvements in outpatient gambling services to the specific needs of this clientele are required.
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Affiliation(s)
- Andreas M. Bickl
- IFT Institut für Therapieforschung, München, Germany,Corresponding author. E-mail:
| | | | | | - Bettina Grüne
- German Youth Institute (DJI), Department of Youth and Youth Services, München, Germany
| | | | - Pawel Sleczka
- German University of Health and Sport, Ismaning, Germany,Seeburg Castle University, Seekirchen am Wallersee, Austria
| | - Jenny Cisneros Örnberg
- Department of Public Health Sciences, Centre for Social Research on Alcohol and Drugs, Stockholm University, Stockholm, Sweden
| | - Ludwig Kraus
- IFT Institut für Therapieforschung, München, Germany,Department of Public Health Sciences, Centre for Social Research on Alcohol and Drugs, Stockholm University, Stockholm, Sweden,Institute of Psychology, ELTE, Eötvös Loránd University, Budapest, Hungary
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Bush R, Russell AMT, Staiger PK, Waling A, Dowling NA. Risk and protective factors for the development of gambling-related harms and problems among Australian sexual minority men. BMC Psychol 2021; 9:102. [PMID: 34187562 PMCID: PMC8240316 DOI: 10.1186/s40359-021-00597-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 05/24/2021] [Indexed: 11/10/2022] Open
Abstract
Background Sexual minority men (SMM) often experience stressful social environments dominated by stigma and discrimination. SMM are typically more likely than heterosexual men to engage in certain risky behaviours such as problem gambling. This study aimed to compare gambling behaviour among SMM and examine potential risk factors (erroneous gambling cognitions, gambling outcome expectancies, hazardous alcohol use, impulsivity, and psychological distress; as well as perceived stigma and discrimination for the SMM participants) and potential protective factors (resilience, social support, and community connectedness) for problem gambling severity and gambling-related harms among SMM living in Australia. Methods An online survey, with an over-representation of SMM participants and problem, moderate-risk, and low-risk gamblers, was completed by 101 SMM (mean age = 28.5) and 207 heterosexual men (mean age = 26.4). Results SMM were found to have significantly lower levels of problem gambling severity compared with heterosexual men, and report significantly lower gambling participation, frequencies and expenditure on any gambling activity, casino table games, horse racing/greyhound betting, sports betting, and keno. However, in the SMM group, 38.3% were classified in the problem gambling category of the Problem Gambling Severity Index and 27.6% were classified in the moderate-risk gambling category. There were no significant differences between groups in gambling-related harms. Multiple regression analyses revealed that problem gambling severity and related harms were independently predicted by higher levels of impulsivity and erroneous gambling cognitions for both groups. Conclusions Lower frequency of gambling behaviours among SMM and similar risk factors predicting problem gambling severity/harms for both groups suggests that problem gambling is not pronounced among SMM. This study adds new evidence to the gambling literature which can be used as comparative benchmarks for future research. Supplementary Information The online version contains supplementary material available at 10.1186/s40359-021-00597-4.
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Affiliation(s)
- Rachel Bush
- School of Psychology, Deakin University, 221 Burwood Highway, BurwoodGeelong, 3125, Australia.
| | - Alex M T Russell
- Experimental Gambling Research Laboratory, School of Health, Medical and Applied Sciences, CQUniversity, Level 6, 400 Kent St, Sydney, NSW, 2000, Australia
| | - Petra K Staiger
- School of Psychology, Deakin University, 221 Burwood Highway, BurwoodGeelong, 3125, Australia.,Centre for Drug Use, Addictive and Anti-Social Behaviour Research (CEDAAR), Deakin University, Geelong, Australia
| | - Andrea Waling
- Australian Research Centre in Sex, Health and Society, NR6, La Trobe University, Bundoora, 3086, Australia
| | - Nicki A Dowling
- School of Psychology, Deakin University, 221 Burwood Highway, BurwoodGeelong, 3125, Australia.,Centre for Drug Use, Addictive and Anti-Social Behaviour Research (CEDAAR), Deakin University, Geelong, Australia.,Melbourne Graduate School of Education, University of Melbourne, Parkville, Australia
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Kraus SW, Potenza MN, Ngo T, Pugh K, Bernice K, Shirk SD. Screening for Gambling Disorder in VA Primary Care Behavioral Health: A Pilot Study. Issues Ment Health Nurs 2020; 41:1076-1082. [PMID: 32783750 DOI: 10.1080/01612840.2020.1793249] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The current pilot study assessed the prevalence of at-risk/problem gambling using the Brief Biosocial Gambling Screen (BBGS) among a sample of U.S. military veterans seeking mental health treatment services in a primary care medical setting at a Veterans Affairs (VA) hospital in the Northeast. Out of the 260 veterans screened, 85 veterans (32.7%) reported gambling behaviors within the past 12 months. No significant differences were found between gambling and non-gambling veterans on demographics, medical, or mental health conditions collected in the study. Among veteran past-year gamblers, five veterans (5.9%) screened positive for at-risk/problem gambling. The estimated prevalence of problem gambling was 1.9% among veterans screened in a primary care behavioral health clinic. Results suggest that self-disclosure of problem gambling among veterans, as well as outreach efforts by VA health care providers, could serve to increase veterans' participation in treatment services for problem gambling. Larger, well-powered studies that examine the utility of the BBGS for detecting problem gambling among military populations are needed.
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Affiliation(s)
- Shane W Kraus
- Department of Psychology, University of Nevada, Las Vegas, Nevada, USA
| | - Marc N Potenza
- Connecticut Council on Problem Gambling, Wethersfield, Connecticut, USA.,Connecticut Mental Health Center, New Haven, Connecticut, USA.,Department of Neuroscience and Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Tu Ngo
- Edith Nourse Rogers Memorial Hospital, Bedford, Massachusetts, USA
| | - Kendra Pugh
- VISN 1 New England MIRECC, Edith Nourse Rogers Memorial Hospital, Bedford, Massachusetts, USA
| | - Katarina Bernice
- VISN 1 New England MIRECC, Edith Nourse Rogers Memorial Hospital, Bedford, Massachusetts, USA
| | - Steven D Shirk
- VISN 1 New England MIRECC, Edith Nourse Rogers Memorial Hospital, Bedford, Massachusetts, USA.,University of Massachusetts Medical School, Worcester, Massachusetts, USA
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Sharman S, Butler K, Roberts A. Psychosocial risk factors in disordered gambling: A descriptive systematic overview of vulnerable populations. Addict Behav 2019; 99:106071. [PMID: 31473572 DOI: 10.1016/j.addbeh.2019.106071] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 07/29/2019] [Accepted: 07/31/2019] [Indexed: 01/23/2023]
Abstract
BACKGROUND Gambling is a behaviour engaged in by millions of people worldwide; for some, gambling can become a severely maladaptive behaviour, and previous research has identified a wide range of psychosocial risk factors that can be considered important for the development and maintenance of disordered gambling. Although risk factors have been identified, the homogeneity of risk factors across specific groups thought to be vulnerable to disordered gambling is to date, unexplored. METHODS To address this, the current review sought to conduct a systematic overview of literature relating to seven vulnerable groups: young people and adolescents, older adults, women, veterans, indigenous peoples, prisoners, and low socio-economic/income groups. RESULTS Multiple risk factors associated with disordered gambling were identified; some appeared consistently across most groups, including being male, co-morbid mental and physical health conditions, substance use disorders, accessibility and availability of gambling, form and mode of gambling, and experience of trauma. Further risk factors were identified that were specific to each vulnerable group. CONCLUSION Within the general population, certain groups are more vulnerable to disordered gambling. Although some risk factors are consistent across groups, some risk factors appear to be group specific. It is clear that there is no homogenous pathway in to disordered gambling, and that social, developmental, environmental and demographic characteristics can all interact to influence an individual's relationship with gambling.
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Affiliation(s)
- Steve Sharman
- University of East London School of Psychology, University of East London, Water Lane, Stratford, London E15 4LZ, United Kingdom.
| | - Kevin Butler
- School of Psychology, University of Lincoln, Brayford Pool, Lincoln LN6 7TS, United Kingdom.
| | - Amanda Roberts
- School of Psychology, University of Lincoln, Brayford Pool, Lincoln LN6 7TS, United Kingdom.
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The Reciprocal Association between Problem Gambling and Mental Health Symptoms/Substance Use: Cross-Lagged Path Modelling of Longitudinal Cohort Data. J Clin Med 2019; 8:jcm8111888. [PMID: 31698740 PMCID: PMC6912817 DOI: 10.3390/jcm8111888] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Revised: 10/29/2019] [Accepted: 10/30/2019] [Indexed: 02/01/2023] Open
Abstract
To date, studies have highlighted cross-sectional and unidirectional prospective relationships between problem gambling and mental health symptoms or substance use. The current study aims to: (1) examine the reciprocal relationships between problem gambling and mental health symptoms (depression, generalized anxiety)/substance use variables (hazardous alcohol use, daily tobacco use, and drug use) using cross-lagged path models in a prospective general population cohort sample; and (2) determine whether these associations are moderated by age and gender. This study involved secondary data analysis from 1109 respondents who provided data during Wave 2 or 3 (12-months apart) of the Tasmanian Longitudinal Gambling Study (Australia). Depression (odds ratio (OR) = 2.164) and generalized anxiety (OR = 2.300) at Wave 2 were found to have cross-lagged associations with the subsequent development of any-risk gambling (low-risk, moderate-risk, or problem gambling) at Wave 3. Hazardous alcohol use, daily tobacco use, and drug use at Wave 2 were not associated with the development of any-risk gambling at Wave 3. Any-risk gambling at Wave 2 was not associated with the subsequent development of any mental health symptoms or substance use variables at Wave 3. Age and gender failed to be significant moderators in the associations between any-risk gambling and mental health symptoms or substance use variables. Future longitudinal and event-level research is required to further substantiate these prospective relationships, with a view to developing targeted preventions and interventions.
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Ronzitti S, Kraus SW, Decker SE, Ashrafioun L. Clinical characteristics of veterans with gambling disorders seeking pain treatment. Addict Behav 2019; 95:160-165. [PMID: 30925440 DOI: 10.1016/j.addbeh.2019.03.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 03/11/2019] [Accepted: 03/21/2019] [Indexed: 01/22/2023]
Abstract
OBJECTIVES To examine the relationships between gambling disorder, pain, and suicide attempts among US military veterans using Veterans Health Administration (VHA) pain-related services. METHODS Retrospective cohort analysis of 221,817 veterans using pain services was included in the analysis. First, differences in sociodemographic and clinical characteristics (i.e., psychiatric comorbidities and pain-related variables) were analyzed according to gambling disorder. Second, we performed logistic regression analyses to assess the association between gambling disorder and suicide attempts. RESULTS Female sex, depressive, alcohol, drug and tobacco use disorders are positively associated with gambling disorders, while severe pain score is negatively associated with gambling disorders. Logistic regression analysis showed that gambling disorder diagnosis was associated suicide attempt in veterans who received a visit for pain in VHA in the past year. CONCLUSIONS Our findings suggest that gambling disorder in female veterans and suicide attempts in veterans with gambling disorder should not be underestimated and warrants further consideration. Moreover, the result that veterans with severe pain may be less likely to have a diagnosis of gambling disorder needs to be confirmed.
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Affiliation(s)
- Silvia Ronzitti
- VA Connecticut Healthcare System, West Haven, CT, USA; Yale University School of Medicine, New Haven, CT, USA.
| | - Shane W Kraus
- VISN 1 New England MIRECC, Edith Nourse Rogers Memorial Veterans Hospital, 200 Spring Road, Building 5, Room 135B, Bedford, MA 01730, United States; University of Massachusetts Medical School, Division of Addiction Psychiatry, 55 Lake Avenue, Worcester, MA 01655, United States
| | - Suzanne E Decker
- VA Connecticut Healthcare System, West Haven, CT, USA; Yale University School of Medicine, New Haven, CT, USA
| | - Lisham Ashrafioun
- VA VISN 2 Center of Excellence for Suicide Prevention, Canandaigua VA Medical Center, 400 Fort Hill Avenue, Canandaigua, NY 14424, USA; Department of Psychiatry, University of Rochester Medical Center, 300 Crittenden Blvd., Rochester, NY 14642, USA
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Grubbs JB, Chapman H. Predicting Gambling Situations: The Roles of Impulsivity, Substance Use, and Post-Traumatic Stress. SUBSTANCE ABUSE-RESEARCH AND TREATMENT 2019; 13:1178221819852641. [PMID: 31258327 PMCID: PMC6591666 DOI: 10.1177/1178221819852641] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 05/02/2019] [Indexed: 12/04/2022]
Abstract
Gambling disorder and symptoms of post-traumatic stress are highly comorbid.
Numerous studies suggest that the presence of one (either disordered gambling or
post-traumatic stress) substantially increases the odds of later developing the
other. However, little is known about the etiological links between these two
domains or the nuances of the comorbidity. Past research has suggested that
symptoms of post-traumatic stress might be related to unique motivations for and
beliefs about gambling. The present work sought to examine whether or not
symptoms of post-traumatic stress might also be related to specific situational
vulnerabilities to gambling behaviors. Using a large cross-sectional sample of
Internet-using adults in the United States who were primarily recreational
gamblers (N = 743; 46% men, Mage = 36.0, SD = 11.1),
as well as an inpatient sample of US Armed Forces veterans seeking treatment for
gambling disorder (N = 332, 80% men, Mage = 53.5,
SD = 11.5), the present work tested whether or not symptoms of post-traumatic
stress were uniquely related to a variety of gambling situations. Results in
both samples revealed that even when controlling for potentially confounding
variables (eg, substance use and trait impulsivity), symptoms of post-traumatic
stress were uniquely related to gambling in response to negative affect,
gambling in response to social pressure, and gambling due to a need for
excitement. These findings are consistent with recent work suggesting that
individuals with post-traumatic stress symptoms are more likely to engage in
gambling behaviors for unique reasons that differ from gamblers without such
symptoms.
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Affiliation(s)
- Joshua B Grubbs
- Department of Psychology, Bowling Green State University, Bowling Green, OH, USA
| | - Heather Chapman
- Gambling Treatment Program, Louis Stokes Cleveland VA Medical Center, Cleveland, OH, USA
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Grubbs JB, Chapman H, Shepherd KA. Post-traumatic stress and gambling related cognitions: Analyses in inpatient and online samples. Addict Behav 2019; 89:128-135. [PMID: 30292070 DOI: 10.1016/j.addbeh.2018.09.035] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 09/06/2018] [Accepted: 09/27/2018] [Indexed: 10/28/2022]
Abstract
Individuals with gambling disorder (GD) report much higher rates of post-traumatic stress symptoms and post-traumatic stress disorder (PTSS/D) than the general population, and individuals with both PTSS/D and GD often report much greater distress and impairment in daily life in comparison to individuals with GD alone (Grubbs, Chapman, Milner, Gutierrez, & Bradley, 2018). Despite these associations, little is known about the specific ways in which PTSS/D and GD might influence each other. To address this gap in research, the present work sought to examine how PTSD might be related to the expression and experience of gambling related cognitions. Specifically, it was hypothesized that individuals with PTSD or symptoms of PTSD (i.e., subclinical levels of post-traumatic stress) would demonstrate greater cognitive distortions and erroneous beliefs about gambling. To test these hypotheses, we analyzed data from two samples, an inpatient sample of U.S. Armed Forces veterans seeking treatment for gambling disorder (n = 332) and an online sample of largely recreational gambling U.S. adults (n = 589). Results consistently revealed that, in both samples, individuals with PTSD or symptoms of PTSD were likely to report greater gambling related cognitions. These findings persisted, even when gambling symptom severity and trait neuroticism were held constant. Collectively, these results suggest that PTSD is uniquely associated with greater cognitive distortions and erroneous beliefs about gambling behaviors. These findings bear distinct implications for current understandings of how PTSS/D and GD are related, as well as for treatment of individuals with dealing with this comorbidity.
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Gambling Disorder in Veterans: A Review of the Literature and Implications for Future Research. J Gambl Stud 2018; 34:1205-1239. [PMID: 29427019 DOI: 10.1007/s10899-018-9749-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
To review the scientific literature examining gambling behavior in military veterans in order to summarize factors associated with gambling behavior in this population. Database searches were employed to identify articles specifically examining gambling behavior in military veterans. Cumulative search results identified 52 articles (1983-2017) examining gambling behavior in veteran populations. Articles generally fell into one or more of the following categories: prevalence, psychological profiles and psychiatric comorbidities, treatment evaluations, measurement, and genetic contributions to gambling disorder. Results from reviewed articles are presented and implications for future research discussed. Research to date has provided an excellent foundation to inform potential screening, intervention and research activities going forward. The authors suggest that a public health approach to future research endeavors would strengthen the evidence base regarding gambling in veteran populations and better inform strategies for screening, prevention and treatment.
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The Economic Burden of Pathological Gambling and Co-occurring Mental Health and Substance Use Disorders. J Addict Med 2018; 12:53-60. [DOI: 10.1097/adm.0000000000000363] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Welte JW, Barnes GM, Tidwell MCO, Wieczorek WF. Predictors of Problem Gambling in the U.S. J Gambl Stud 2016; 33:327-342. [DOI: 10.1007/s10899-016-9639-1] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Grall-Bronnec M, Caillon J, Humeau E, Perrot B, Remaud M, Guilleux A, Rocher B, Sauvaget A, Bouju G. Gambling among European professional athletes. Prevalence and associated factors. J Addict Dis 2016; 35:278-290. [PMID: 27111296 DOI: 10.1080/10550887.2016.1177807] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
In Europe, the prevalence of gambling disorders in the general population ranges from 0.15 to 6.6%. Professional athletes are known for having risk factors for addictive behaviors, such as young age or sensation seeking, though no study has yet tried to evaluate the prevalence of gambling and gambling disorders among this specific population. The goals of this study were to estimate the prevalence of gambling, problematic or not, among European professional athletes and to explore the factors that are associated with gambling practice and gambling problems in professional athletes. A self-completion questionnaire was specifically designed for this study. The questionnaires were distributed by European Union athletes to professional ice hockey, rugby, handball, basketball, football, indoor football, volleyball, and cricket teams in Spain, France, Greece, Ireland, Italy, Sweden, and the United Kingdom. Socio-demographic variables (age, sex, education, marital and parental status, sport, country of birth, and country of practice), variables linked to gambling (gambling habits, screening of gambling problems with the Lie/Bet questionnaire, and gambling related cognitions), and impulsive behavior data (urgency, premeditation, perseverance, and sensation seeking [UPPS]-Short Form questionnaire) were gathered. There were 1,236 questionnaires filled out. The percentage of professional athletes that had gambled at least once during the previous year was 56.6%. The prevalence of problem gambling, current or past, was 8.2%. A certain number of variables were associated with the gambling status. In particular, betting on one's own team (OR = 4.1, CI95% [1.5-11.5]), betting online (OR = 2.9, CI95% [1.6-5.4]), gambling regularly (OR = 4.0, CI95% [2.1-7.6]), and having a high positive urgency score (OR = 1.5, CI95% [1.3-1.7]) were associated with gambling problems, current or past, among professional athletes. Professional athletes are particularly exposed to both gambling and problem gambling.
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Affiliation(s)
- Marie Grall-Bronnec
- a Clinical Investigation Unit BALANCED "BehaviorAL AddictioNs and ComplEx mood Disorders," Addictology and Psychiatry Department, Nantes University Hospital , Nantes , France.,b EA 4275 SPHERE "bioStatistics, Pharmacoepidemiology and Human sciEnces Research tEam," Nantes University , Nantes , France
| | - Julie Caillon
- a Clinical Investigation Unit BALANCED "BehaviorAL AddictioNs and ComplEx mood Disorders," Addictology and Psychiatry Department, Nantes University Hospital , Nantes , France.,b EA 4275 SPHERE "bioStatistics, Pharmacoepidemiology and Human sciEnces Research tEam," Nantes University , Nantes , France
| | - Elise Humeau
- a Clinical Investigation Unit BALANCED "BehaviorAL AddictioNs and ComplEx mood Disorders," Addictology and Psychiatry Department, Nantes University Hospital , Nantes , France
| | - Bastien Perrot
- b EA 4275 SPHERE "bioStatistics, Pharmacoepidemiology and Human sciEnces Research tEam," Nantes University , Nantes , France
| | - Manon Remaud
- a Clinical Investigation Unit BALANCED "BehaviorAL AddictioNs and ComplEx mood Disorders," Addictology and Psychiatry Department, Nantes University Hospital , Nantes , France.,b EA 4275 SPHERE "bioStatistics, Pharmacoepidemiology and Human sciEnces Research tEam," Nantes University , Nantes , France
| | - Alice Guilleux
- b EA 4275 SPHERE "bioStatistics, Pharmacoepidemiology and Human sciEnces Research tEam," Nantes University , Nantes , France
| | - Bruno Rocher
- a Clinical Investigation Unit BALANCED "BehaviorAL AddictioNs and ComplEx mood Disorders," Addictology and Psychiatry Department, Nantes University Hospital , Nantes , France
| | - Anne Sauvaget
- a Clinical Investigation Unit BALANCED "BehaviorAL AddictioNs and ComplEx mood Disorders," Addictology and Psychiatry Department, Nantes University Hospital , Nantes , France
| | - Gaelle Bouju
- a Clinical Investigation Unit BALANCED "BehaviorAL AddictioNs and ComplEx mood Disorders," Addictology and Psychiatry Department, Nantes University Hospital , Nantes , France.,b EA 4275 SPHERE "bioStatistics, Pharmacoepidemiology and Human sciEnces Research tEam," Nantes University , Nantes , France
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Problem współwystępowania zaburzeń hazardowych z zaburzeniami psychicznymi. Przegląd literatury. ALCOHOLISM AND DRUG ADDICTION 2016. [DOI: 10.1016/j.alkona.2016.03.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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A focus group study of predictors of relapse in electronic gaming machine problem gambling, part 1: factors that 'push' towards relapse. J Gambl Stud 2012; 28:451-64. [PMID: 21901457 DOI: 10.1007/s10899-011-9264-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
This study aimed to develop an empirically based description of relapse in Electronic Gaming Machine problem gambling. In this paper the authors describe part one of a two part, linked relapse process: the 'push' towards relapse. In this two-part process, factors interact sequentially and simultaneously within the problem gambler to produce a series of mental and behavioural events that ends with relapse when the 'push' overcomes 'pull' (part one); or as described in part two, continued abstinence when 'pull' overcomes 'push'. In the second paper, the authors describe how interacting factors 'pull' the problem gambler away from relapse. This study used four focus groups comprising thirty participants who were gamblers, gamblers' significant others, therapists and counsellors. The groups were recorded, recordings were then transcribed and analysed using thematic, textual analysis. With the large number of variables considered to be related to relapse in problem gamblers, five key factors emerged that 'push' the gambler towards relapse. These were urge, erroneous cognitions about the outcomes of gambling, negative affect, dysfunctional relationships and environmental gambling triggers. Two theories emerged: (1) each relapse episode comprised a sequence of mental and behavioural events, which evolves over time and was modified by factors that 'push' this sequence towards relapse and (2) a number of gamblers develop an altered state of consciousness during relapse described as the 'zone' which prolongs the relapse.
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Shenassa ED, Paradis AD, Dolan SL, Wilhelm CS, Buka SL. Childhood impulsive behavior and problem gambling by adulthood: a 30-year prospective community-based study. Addiction 2012; 107:160-8. [PMID: 21752146 PMCID: PMC4445841 DOI: 10.1111/j.1360-0443.2011.03571.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIMS Problem gambling can create major financial, emotional and sometimes criminal problems for an individual. This study prospectively investigated the association between impulsive behavior at age 7 and the development of life-time problem gambling by adulthood. We also examined the specificity of any observed association between impulsive behaviors and problem gambling by conducting parallel analyses examining the link between respondents' shy/depressed behavior in childhood and later problem gambling. DESIGN, SETTING AND PARTICIPANTS Cohort study of 958 offspring of mothers enrolled in the Collaborative Perinatal Project who participated in an adult follow-up study at a mean age of 39.2 years. MEASUREMENTS Multivariable logistic regression models were fitted to determine associations between psychologist-rated impulsive and shy/depressed behaviors at age 7 and life-time self-reported gambling as measured by the South Oaks Gambling Screen administered during the adult follow-up study. FINDINGS Children who exhibited impulsive behaviors at age 7, compared to their non-impulsive counterparts, were 3.09 (95% confidence interval: 1.40-6.82) times as likely to report problem gambling years later. In contrast, we did not find a significant association between childhood shy/depressed behavior and problem gambling by adulthood in adjusted analyses. CONCLUSIONS Impulsive behaviors at age 7 are a specific and significant risk factor for later problem gambling.
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Affiliation(s)
- Edmond D. Shenassa
- Maternal and Child Health program, Department of Family Science, School of Public Health, University of Maryland, College Park, MD, USA,Division of Epidemiology, Department of Community Health, Brown School of Medicine, Providence, RI, USA
| | - Angela D. Paradis
- Division of Epidemiology, Department of Community Health, Brown School of Medicine, Providence, RI, USA,Department of Society, Human Development and Health, Harvard School of Public Health, Boston, MA, USA
| | - Sara L. Dolan
- Department of Psychology and Neuroscience, Baylor University, Waco, TX, USA
| | - Charlotte S. Wilhelm
- Division of Epidemiology, Department of Community Health, Brown School of Medicine, Providence, RI, USA
| | - Stephen L. Buka
- Division of Epidemiology, Department of Community Health, Brown School of Medicine, Providence, RI, USA
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Carragher N, McWilliams LA. A latent class analysis of DSM-IV criteria for pathological gambling: Results from the National Epidemiologic Survey on Alcohol and Related Conditions. Psychiatry Res 2011; 187:185-92. [PMID: 21247638 DOI: 10.1016/j.psychres.2010.12.022] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2010] [Revised: 11/03/2010] [Accepted: 12/09/2010] [Indexed: 11/24/2022]
Abstract
With rapid increases in gambling opportunities over the past decade, gambling has emerged as an important social and public health concern. The pending revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM) has prompted a flurry of empirical research evaluating the extant diagnostic classification scheme; however few studies have evaluated the pathological gambling criteria. This paper utilized latent class analysis (LCA) to empirically derive and validate a typology of gamblers. LCA was applied to the 10 DSM-IV pathological gambling criteria utilizing data from the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (n=11,104). LCA identified three latent classes which largely differed according to severity. The majority of respondents were assigned to the no gambling problems class (93.3%). Gamblers in the moderate gambling problems class (6.1%) primarily endorsed the preoccupation, tolerance, and chasing criteria. The pervasive gambling problems class (0.6%) endorsed the majority of the criteria. A number of significant differences between the classes emerged as a function of demographic, psychiatric and substance use disorders. The findings offer a heuristic and clinically useful typology of gamblers. Support for a continuum of gambling-related problems reiterate the need for assessment, prevention, and treatment strategies that reflect this more nuanced understanding of gambling.
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Affiliation(s)
- Natacha Carragher
- National Drug and Alcohol Research Centre, University of NSW, Sydney, NSW 2052, Australia.
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Poletti M, Cavedini P, Bonuccelli U. Iowa Gambling Task in Parkinson's Disease. J Clin Exp Neuropsychol 2010; 33:395-409. [PMID: 21140314 DOI: 10.1080/13803395.2010.524150] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
- Michele Poletti
- a Neurology Unit, Unità Sanitaria Locale of Viareggio , Viareggio, Italy
- b Department of Neuroscience , University of Pisa , Pisa, Italy
| | - Paolo Cavedini
- c Department of Clinical Neurosciences , Villa San Benedetto Hospital, Hermanas Hospitalarias , Albese con Cassano, Italy
| | - Ubaldo Bonuccelli
- a Neurology Unit, Unità Sanitaria Locale of Viareggio , Viareggio, Italy
- b Department of Neuroscience , University of Pisa , Pisa, Italy
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Quilty LC, Watson C, Robinson JJ, Toneatto T, Bagby RM. The Prevalence and Course of Pathological Gambling in the Mood Disorders. J Gambl Stud 2010; 27:191-201. [DOI: 10.1007/s10899-010-9199-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Grant JE, Schreiber L, Odlaug BL, Kim SW. Pathologic gambling and bankruptcy. Compr Psychiatry 2010; 51:115-20. [PMID: 20152290 PMCID: PMC2824911 DOI: 10.1016/j.comppsych.2009.04.002] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2009] [Revised: 04/15/2009] [Accepted: 04/17/2009] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Although prior studies have examined rates of bankruptcy in pathologic gambling (PG), there are only limited data regarding the clinical correlates of those with PG who declare bankruptcy because of gambling. METHOD Five hundred seventeen consecutive subjects with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, PG (54.7% females; mean age 47.6 years) were grouped into 2 categories: those who had (n = 93; 18.0%) and had not (n = 424; 82.0%) declared bankruptcy secondary to gambling. Groups were compared on clinical characteristics, gambling severity (using the Yale-Brown Obsessive-Compulsive Scale Modified for Pathological Gambling, Gambling Symptom Assessment Scale; Clinical Global Impression-severity scale, and time and money spent gambling), and psychiatric comorbidity. RESULTS Gamblers who had declared bankruptcy were more likely to be single (P = .004); have an earlier age of problem gambling onset (P = .032); and have more financial (P < .001), work-related (P = .006), marital (P < .001), and legal (P < .001) problems secondary to their gambling. They also reported higher rates of depressive disorders (P < .001), substance use disorders (P = .005) and were more likely to be daily users of nicotine (P = .022). Money spent gambling did not differ significantly between groups. CONCLUSION These preliminary results suggest that bankruptcy in PG may be associated with specific clinical differences. Treatment strategies may want to assess bankruptcy status to develop more effective treatments that take account of these clinical differences.
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Lobo DSS, Kennedy JL. Genetic aspects of pathological gambling: a complex disorder with shared genetic vulnerabilities. Addiction 2009; 104:1454-65. [PMID: 19686516 DOI: 10.1111/j.1360-0443.2009.02671.x] [Citation(s) in RCA: 83] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
AIMS To summarize and discuss findings from genetic studies conducted on pathological gambling (PG). METHODS Searches were conducted on PubMed and PsychInfo databases using the keywords: 'gambling and genes', 'gambling and family' and 'gambling and genetics', yielding 18 original research articles investigating the genetics of PG. RESULTS Twin studies using the Vietnam Era Twin Registry have found that: (i) the heritability of PG is estimated to be 50-60%; (ii) PG and subclinical PG are a continuum of the same disorder; (iii) PG shares genetic vulnerability factors with antisocial behaviours, alcohol dependence and major depressive disorder; (iv) genetic factors underlie the association between exposure to traumatic life-events and PG. Molecular genetic investigations on PG are at an early stage and published studies have reported associations with genes involved in the brain's reward and impulse control systems. CONCLUSIONS Despite the paucity of studies in this area, published studies have provided considerable evidence of the influence of genetic factors on PG and its complex interaction with other psychiatric disorders and environmental factors. The next step would be to investigate the association and interaction of these variables in larger molecular genetic studies with subphenotypes that underlie PG. Results from family and genetic investigations corroborate further the importance of understanding the biological underpinnings of PG in the development of more specific treatment and prevention strategies.
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Affiliation(s)
- Daniela S S Lobo
- Centre for Addiction and Mental Health, Neurogenetics Laboratory, University of Toronto, 250 College Street, R 30, Toronto, ON M5T1R8, Canada.
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BAKKEN INGERJOHANNE, GÖTESTAM KGUNNAR, GRÅWE ROLFW, WENZEL HANNEGRO, ØREN ANITA. Gambling behavior and gambling problems in Norway 2007. Scand J Psychol 2009; 50:333-9. [DOI: 10.1111/j.1467-9450.2009.00713.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Pathological Gambling in Estonia: Relationships with Personality, Self-Esteem, Emotional States and Cognitive Ability. J Gambl Stud 2009; 25:377-90. [DOI: 10.1007/s10899-009-9119-y] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2008] [Accepted: 02/02/2009] [Indexed: 11/27/2022]
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Rush BR, Bassani DG, Urbanoski KA, Castel S. Influence of co-occurring mental and substance use disorders on the prevalence of problem gambling in Canada. Addiction 2008; 103:1847-56. [PMID: 19032535 DOI: 10.1111/j.1360-0443.2008.02338.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
CONTEXT/BACKGROUND Research has shown that problem gambling (PG) is associated with substance use disorders (SUD) and also with other mental disorders (MD). Nevertheless, evidence about the relative contribution of each type of disorder for the risk of gambling in the population is very limited. OBJECTIVE Study the association of SUD, alone and in combination with MD, with the prevalence and severity of PG. DESIGN Cross-sectional national survey (Canadian Community Health Survey-Mental Health and Well-Being) data collected through a multi-stage stratified cluster design. SETTING Population-based household survey. PARTICIPANTS This analysis includes data on 36 885 participants (99.7% of the survey sample). MAIN OUTCOME MEASURES The prevalence and severity of PG were measured using the Canadian Problem Gambling Index. Prevalence of MD (mood and anxiety disorders) and SUD were defined according to the World Mental Health Survey Initiative Composite International Diagnostic Interview, following definitions of the DSM-IV. RESULTS Compared to the population, higher prevalence rates of PG are observed when the severity of SUD is higher, but are not impacted by the co-occurrence of MD. For individuals with low risk and moderate risk/problem gambling, the prevalence rate difference (prevalence rate in the subgroup minus prevalence rate in the population) observed among substance dependents was reduced when MD co-occurred (from a prevalence rate difference of 2.5; 99% confidence interval 1.6-3.8 to 1.6; 99% confidence interval 1.2-2.2 for low risk gamblers and from 3.7; 99% confidence interval 1.6-5.5 to 2.9; 99% confidence interval 2.0-4.3 for moderate risk/problem gamblers). Estimates were not statistically different. CONCLUSIONS Prevalence of all levels of PG increased with SUD severity, but the pattern did not appear to be affected by MD co-occurrence. Results suggest particular attention be given to SUD in treatment-seeking clients with co-occurring disorders.
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Affiliation(s)
- Brian R Rush
- Health Systems Research and Consulting Unit, Centre for Addiction and Mental Health, Toronto, ON, Canada.
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Kessler RC, Hwang I, LaBrie R, Petukhova M, Sampson NA, Winters KC, Shaffer HJ. DSM-IV pathological gambling in the National Comorbidity Survey Replication. Psychol Med 2008; 38:1351-1360. [PMID: 18257941 PMCID: PMC2293303 DOI: 10.1017/s0033291708002900] [Citation(s) in RCA: 569] [Impact Index Per Article: 35.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Little is known about the prevalence or correlates of DSM-IV pathological gambling (PG). METHOD Data from the US National Comorbidity Survey Replication (NCS-R), a nationally representative US household survey, were used to assess lifetime gambling symptoms and PG along with other DSM-IV disorders. Age of onset (AOO) of each lifetime disorder was assessed retrospectively. AOO reports were used to study associations between temporally primary disorders and the subsequent risk of secondary disorders. RESULTS Most respondents (78.4%) reported lifetime gambling. Lifetime problem gambling (at least one Criterion A symptom of PG) (2.3%) and PG (0.6%) were much less common. PG was significantly associated with being young, male, and Non-Hispanic Black. People with PG reported first gambling significantly earlier than non-problem gamblers (mean age 16.7 v. 23.9 years, z=12.7, p<0.001), with gambling problems typically beginning during the mid-20s and persisting for an average of 9.4 years. During this time the largest annual gambling losses averaged US$4800. Onset and persistence of PG were predicted by a variety of prior DSM-IV anxiety, mood, impulse-control and substance use disorders. PG also predicted the subsequent onset of generalized anxiety disorder, post-traumatic stress disorder (PTSD) and substance dependence. Although none of the NCS-R respondents with PG ever received treatment for gambling problems, 49.0% were treated at some time for other mental disorders. CONCLUSIONS DSM-IV PG is a comparatively rare, seriously impairing, and undertreated disorder whose symptoms typically start during early adulthood and is frequently secondary to other mental or substance disorders that are associated with both PG onset and persistence.
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Affiliation(s)
- R C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA 02115, USA.
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