title: Investigating Veterans' Pre-, Peri-, and Post-Deployment Experiences as Potential Risk Factors for Problem Gambling.
abstract: Background and aims Gambling disorder and its comorbid diagnoses are observed at higher rates in military veterans than in the general population. A significant research gap exists regarding the relationships of veterans' life and service experiences to problematic gambling. The present study explored pre-, peri-, and post-deployment factors associated with problem gambling in veterans. Methods Veterans of Operation Iraqi Freedom, Operation Enduring Freedom, and Operation New Dawn (n = 738; 463 males, and 275 females) completed questionnaires via structured telephone interview. We conducted bivariate and multinomial logistic regression analyses exploring associations among problem-gambling severity and socio-demographic variables, psychiatric comorbidities, and 10 scales of the Deployment Risk and Resilience Inventory measuring experiences pre-, peri-, and post-deployment. Results Approximately 4.2% of veterans indicated at-risk or probable pathological gambling (ARPG) post-deployment (two or more DSM-IV criteria for pathological gambling). Bivariate analyses found more severe gambling in males, higher frequencies of post-traumatic stress disorder, substance dependence, traumatic brain injury, panic disorder, and depression in veterans with ARPG, and higher general harassment during deployment, and lower social support and more stressful life events post-deployment in those with ARPG. In multivariable models, both post-deployment factors remained significantly associated with ARPG. Discussion The study suggests that problem gambling among veterans is related to service experiences, and particularly to life experiences post-deployment. Conclusions Adverse service and life experiences and lack of social support may contribute to the risk of problem gambling in military veterans. Investigation of how Veterans Affairs clinical settings may serve veterans following deployment to prevent behavioral addictions is warranted.
authors.affiliation: Department of Veterans Affairs, VISN 1 Mental Illness Research Education and Clinical Center (MIRECC) , West Haven, CT, USA.|Department of Psychiatry, Yale University School of Medicine , New Haven, CT, USA.
authors.forename: Seth W
authors.initials: SW
authors.lastname: Whiting
authors.affiliation: Department of Psychiatry, Yale University School of Medicine , New Haven, CT, USA.|Department of Neurobiology, Yale University School of Medicine , New Haven, CT, USA.|Child Study Center, Yale University School of Medicine , New Haven, CT, USA.
authors.forename: Marc N
authors.initials: MN
authors.lastname: Potenza
authors.affiliation: Department of Psychology, University of Connecticut , Storrs, CT, USA.
authors.forename: Crystal L
authors.initials: CL
authors.lastname: Park
authors.affiliation: Department of Psychiatry, Yale University School of Medicine , New Haven, CT, USA.
authors.forename: Sherry A
authors.initials: SA
authors.lastname: McKee
authors.affiliation: Department of Psychiatry, Yale University School of Medicine , New Haven, CT, USA.
authors.forename: Carolyn M
authors.initials: CM
authors.lastname: Mazure
authors.affiliation: Department of Veterans Affairs, VISN 1 Mental Illness Research Education and Clinical Center (MIRECC) , West Haven, CT, USA.|Department of Psychiatry, Yale University School of Medicine , New Haven, CT, USA.
authors.forename: Rani A
authors.initials: RA
authors.lastname: Hoff
mesh_terms: D000328:Adult; D055826:Afghan Campaign 2001-; D000368:Aged; D015897:Comorbidity; D005260:Female; D005715:Gambling / Q000150:complications / Q000453:epidemiology* / Q000523:psychology*; D006801:Humans; D007407:Interviews as Topic; D054542:Iraq War, 2003-2011; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D055500:Resilience, Psychological; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D013313:Stress Disorders, Post-Traumatic / Q000150:complications / Q000453:epidemiology; D013997:Time Factors; D014728:Veterans / Q000523:psychology* / Q000706:statistics & numerical data; D000067453:War Exposure / Q000009:adverse effects* / Q000706:statistics & numerical data; D055815:Young Adult
keywords: deployment experiences; gambling; military; veterans