title: DSM-based problem gambling: increasing the odds of heavy drinking in a national sample of U.S. college athletes?
abstract: Despite previously found co-occurrence of youth gambling and alcohol use, their relationship has not been systematically explored in a national sample using DSM-based gambling measures and multivariate modeling, adjusted for potential confounders. This study aimed to empirically examine the prevalence patterns and odds of at-least-weekly alcohol use and heavy episodic drinking (HED) in relation to various levels of gambling severity in college athletes. Multivariate logistic regression analyses were performed on data from a national sample of 20,739 U.S. college athletes from the first National Collegiate Athletic Association national survey of gambling and health-risk behaviors. Prevalence of at-least-weekly alcohol use significantly increased as DSM-IV-based gambling severity increased, from non-gambling (24.5%) to non-problem gambling (43.7%) to sub-clinical gambling (58.5%) to problem gambling (67.6%). Multivariate results indicated that all levels of gambling were associated with significantly elevated risk of at-least-weekly HED, from non-problem (OR = 1.25) to sub-clinical (OR = 1.75) to problem gambling (OR = 3.22); the steep increase in the relative risk also suggested a possible quadratic relationship between gambling level and HED risk. Notably, adjusted odds ratios showed problem gambling had the strongest association with at-least-weekly HED, followed by marijuana (OR = 3.08) and cigarette use (OR = 2.64). Gender interactions and differences were also identified and assessed. In conclusion, attention should be paid to college athletes exhibiting gambling problems, especially considering their empirical multivariate associations with high-risk drinking; accordingly, screening for problem gambling is recommended. More research is warranted to elucidate the etiologic mechanisms of these associations.
authors.affiliation: Institute of Health Policy and Management, College of Public Health, National Taiwan University, 17 Xu-Zhou Road, Taipei 10055, Taiwan. jhuang@ntu.edu.tw
authors.forename: Jiun-Hau
authors.initials: JH
authors.lastname: Huang
authors.forename: Durand F
authors.initials: DF
authors.lastname: Jacobs
authors.forename: Jeffrey L
authors.initials: JL
authors.lastname: Derevensky
mesh_terms: D000328:Adult; D000367:Age Factors; D000428:Alcohol Drinking / Q000453:epidemiology*; D056352:Athletes / Q000523:psychology*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D005715:Gambling / Q000175:diagnosis* / Q000453:epidemiology*; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D015995:Prevalence; D013334:Students / Q000523:psychology; D014481:United States / Q000453:epidemiology; D014495:Universities; D055815:Young Adult