title: Towards a comprehensive developmental model of pathological gambling.
abstract: OBJECTIVE
  To develop a comprehensive etiological model of pathological gambling (PG) for men and women based on Kendler's development model for major depression, which groups 22 risk factors into five developmental tiers (childhood, early adolescence, late adolescence, adulthood, last year). We hypothesized that: (1) all risk factors would be associated significantly with PG; (2) the effect of risk factors in earlier developmental tiers would be accounted for by later tiers; and (3) there would be few gender differences.
  
  
  METHODS
  Separate models were built for life-time gambling and for 12-month PG among those with life-time gambling.
  
  
  METHODS
  Data drawn from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) in the United States.
  
  
  METHODS
  Respondents to NESARC wave 1 (n = 43 093).
  
  
  METHODS
  Odds ratios (OR) and adjusted OR (AOR) were used to determine the risk factors in multiple models.
  
  
  RESULTS
  After mutually adjusting for other risk factors, family history of substance use disorders (SUD) or depression, impulsivity, childhood-onset anxiety, number of Axis I and II disorders, history of SUD, nicotine dependence, social deviance in adulthood, and past-year history of SUD, nicotine dependence and independent stressful life events predicted life-time gambling. Past history of PG, number of personality disorders and past year nicotine dependence were associated significantly with 12-month PG (all P < 0.05). There were no significant gender interactions for 12-month PG.
  
  
  CONCLUSIONS
  A modification of Kendler's model for major depression provides a foundation for the development of a comprehensive developmental model of pathological gambling. Life-time history of gambling and 12-month pathological gambling appear to be determined by risk factors in several developmental levels, with the effect of earlier development tiers accounted for by later ones.
authors: Department of Psychiatry, New York State Psychiatric Institute/Columbia University, New York, NY, USA.
authors: Carlos
authors: C
authors: Blanco
authors: Department of Psychiatry, New York State Psychiatric Institute/Columbia University, New York, NY, USA.
authors: Joan
authors: J
authors: Hanania
authors: Department of Medicine, University of Connecticut, USA.
authors: Nancy M
authors: NM
authors: Petry
authors: Department of Psychiatry, New York State Psychiatric Institute/Columbia University, New York, NY, USA.
authors: Melanie M
authors: MM
authors: Wall
authors: Department of Psychiatry, New York State Psychiatric Institute/Columbia University, New York, NY, USA.
authors: Shuai
authors: S
authors: Wang
authors: Department of Psychiatry, New York State Psychiatric Institute/Columbia University, New York, NY, USA.
authors: Chelsea J
authors: CJ
authors: Jin
authors: Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA.
authors: Kenneth S
authors: KS
authors: Kendler
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D001007:Anxiety / Q000453:epidemiology; D003863:Depression / Q000453:epidemiology; D005260:Female; D005715:Gambling / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D007175:Impulsive Behavior; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D010554:Personality Disorders / Q000453:epidemiology; D012307:Risk Factors; D057566:Self Report; D017678:Sex Distribution; D012920:Social Behavior Disorders / Q000453:epidemiology; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: Addictive disorders; NESARC; developmental model; pathological gambling