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Gambling in a National U.S. Veteran Population: Prevalence, Socio-demographics, and Psychiatric Comorbidities

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Abstract

This study aimed to examine associations between gambling level and clinically relevant measures, including psychiatric disorders and suicidality, in a nationally representative sample of U.S. veterans. Data on 3157 U.S. veterans were analyzed from the National Health and Resilience in Veterans Study. Chi square tests and analyses of variance were used to assess associations between gambling level, and demographic, military, and personality characteristics. Multinomial logistic regressions using stepwise selection were used to identify independent correlates of recreational gambling and at-risk/problem gambling (ARPG). A significant proportion of U.S. veterans engage in gambling activities, with 35.1% gambling recreationally and 2.2% screening positive for ARPG. ARPG was associated with greater prevalence of substance use, anxiety, and depressive disorders, as well as with a history of physical trauma or sexual trauma, having sought mental health treatment (particularly from the Veterans Administration), and minority group status. A similar pattern was found associated with recreational gambling, although the magnitudes of association were lower relative to ARPG. Younger age, self-identifying as black, being retired, and trauma burden were associated with increased odds of ARPG, whereas older age, being single, non-white Hispanic, being retired or not having a job, screening positive for alcohol- and drug-use disorders, and trauma burden were associated with increased odds of recreational gambling. More than a third of U.S. veterans gamble recreationally, with a significant minority (2.2%) screening positive for ARPG. Both recreational and ARPG were associated with elevated trauma burden and psychiatric comorbidities. These findings underscore the importance of routine screening and monitoring of gambling severity, and interventions for ARPG in this population.

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Authors and Affiliations

  1. Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA

    Elina A. Stefanovics, Marc N. Potenza & Robert H. Pietrzak

  2. U.S. Department of Veterans Affairs New England Mental Illness, Research, and Education Clinical Center (MIRECC), VA Connecticut Healthcare System (116A-4), 950 Campbell AvenueBuilding 36, West Haven, CT, 06516, USA

    Elina A. Stefanovics

  3. Department of Neuroscience and Child Study Center, Yale University School of Medicine, New Haven, CT, USA

    Marc N. Potenza

  4. National Center on Addiction and Substance Abuse, Yale University School of Medicine, New Haven, CT, USA

    Marc N. Potenza

  5. Connecticut Mental Health Center, New Haven, CT, USA

    Marc N. Potenza

  6. Center of Excellence in Gambling Research, Yale Program for Research on Impulsivity and Impulse Control Disorders, Yale University School of Medicine, New Haven, CT, USA

    Marc N. Potenza

  7. U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, USA

    Robert H. Pietrzak

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  1. Elina A. Stefanovics
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Correspondence to Elina A. Stefanovics.

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Conflict of interest

The authors report no conflicts of interest with respect to the content of the manuscript. Drs. Stefanovics and Pietrzak report no conflict of interest. Dr. Potenza discloses the following activities. He has consulted for and advised Ironwood, Lundbeck, INSYS, Shire, RiverMend Health and Jazz Pharmaceuticals; has received research support from Mohegan Sun Casino, the National Center for Responsible Gaming, and Pfizer; has participated in surveys, mailings, or telephone consultations related to drug addiction, impulse control disorders, or other health topics; has consulted for legal entities on issues related to impulse control and addictive disorders; provides clinical care in the Connecticut Department of Mental Health and Addiction Services Problem Gambling Services Program; has performed grant reviews for the National Institutes of Health and other agencies; has edited journals or journal sections; has given academic lectures in grand rounds, CME events and other clinical or scientific venues; and has generated books or book chapters for publishers of mental health texts.

Ethical Approval

The study was approved by the Human Subject Subcommittee of the VA Connecticut Healthcare System.

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All participants provided informed consent.

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Stefanovics, E.A., Potenza, M.N. & Pietrzak, R.H. Gambling in a National U.S. Veteran Population: Prevalence, Socio-demographics, and Psychiatric Comorbidities. J Gambl Stud 33, 1099–1120 (2017). https://doi.org/10.1007/s10899-017-9678-2

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