title: The relationship between age of gambling onset and adolescent problematic gambling severity.
abstract: The aim of this study was to characterize the association between problem gambling severity and multiple health, functioning and gambling variables in adolescents aged 13-18 stratified by age of gambling onset. Survey data in 1624 Connecticut high school students stratified by age of gambling onset (≤ 11 years vs. ≥ 12 years) were analyzed in descriptive analyses and in logistic regression models. Earlier age of onset was associated with problem gambling severity as indexed by a higher frequency of at-risk/problem gambling (ARPG). Most health, functioning and gambling measures were similarly associated with problem gambling severity in the earlier- and later-age-of-gambling-onset groups with the exception of participation in non-strategic forms of gambling, which was more strongly associated with ARPG in the earlier-onset (OR = 1.74, 95%CI = [1.26, 2.39]) as compared to later-onset (OR = 0.94, 95%CI = [0.60, 1.48]) group (Interaction OR = 1.91, 95%CI = [1.18, 3.26]). Post-hoc analysis revealed that earlier-onset ARPG was more strongly associated with multiple forms of non-strategic gambling including lottery (instant, traditional) and slot-machine gambling. The finding that problem gambling severity is more closely associated with multiple non-strategic forms of gambling amongst youth with earlier-onset gambling highlights the relevance of these types of youth gambling. The extent to which non-strategic forms of gambling may serve as a gateway to other forms of gambling or risk behaviors warrants additional study, and efforts targeting youth gambling should consider how best to address non-strategic gambling through education, prevention, treatment and policy efforts.
authors.affiliation: Department of Psychiatry, Yale University School of Medicine, Connecticut Mental Health Center, New Haven, CT 06519, United States.
authors.forename: Ardeshir S
authors.initials: AS
authors.lastname: Rahman
authors.forename: Corey E
authors.initials: CE
authors.lastname: Pilver
authors.forename: Rani A
authors.initials: RA
authors.lastname: Desai
authors.forename: Marvin A
authors.initials: MA
authors.lastname: Steinberg
authors.forename: Loreen
authors.initials: L
authors.lastname: Rugle
authors.forename: Suchitra
authors.initials: S
authors.lastname: Krishnan-Sarin
authors.forename: Marc N
authors.initials: MN
authors.lastname: Potenza
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology; D017668:Age of Onset; D000375:Aging / Q000523:psychology*; D016009:Chi-Square Distribution; D005260:Female; D005715:Gambling / Q000453:epidemiology*; D006304:Health Status; D006801:Humans; D016015:Logistic Models; D008297:Male; D011569:Psychiatric Status Rating Scales; D012309:Risk-Taking