title: Relationships Between Problem-Gambling Severity and Psychopathology as Moderated by Income.
abstract: Background and aims Problem and pathological gambling have been associated with elevated rates of both Axis-I and Axis-II psychiatric disorders. Although both problem gambling and psychiatric disorders have been reported as being more prevalent among lower income vs. middle/higher income groups, how income might moderate the relationship between problem-gambling severity and psychopathology is incompletely understood. To examine the associations between problem-gambling severity and psychopathology in lower income and middle/higher income groups. Methods Data from the first wave of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) (n = 43,093) were analyzed in adjusted logistic regression models to investigate the relationships between problem-gambling severity and psychiatric disorders within and across income groups. Results Greater problem-gambling severity was associated with increased odds of multiple psychiatric disorders for both lower income and middle/higher income groups. Income moderated the association between problem/pathological gambling and alcohol abuse/dependence, with a stronger association seen among middle/higher income respondents than among lower income respondents. Discussion and conclusions The findings that problem-gambling severity is related to psychopathology across income groups suggest a need for public health initiatives across social strata to reduce the impact that problem/pathological gambling may have in relation to psychopathology. Middle/higher income populations, perhaps owing to the availability of more "disposable income," may be at greater risk for co-occurring gambling and alcohol-use psychopathology and may benefit preferentially from interventions targeting both gambling and alcohol use.
authors.affiliation: 1 Yale Child Study Center, Yale University School of Medicine , New Haven, CT, USA.|2 University of Connecticut , Storrs, CT, USA.
authors.forename: Rachel L
authors.initials: RL
authors.lastname: Sanacora
authors.affiliation: 3 Department of Veterans Affairs, VISN 1 Mental Illness Research Education and Clinical Center , West Haven, CT, USA.|4 Department of Psychiatry, Yale University School of Medicine , New Haven, CT, USA.
authors.forename: Seth W
authors.initials: SW
authors.lastname: Whiting
authors.affiliation: 5 Department of Biostatistics, Yale School of Public Health , New Haven, CT, USA.
authors.forename: Corey E
authors.initials: CE
authors.lastname: Pilver
authors.affiliation: 3 Department of Veterans Affairs, VISN 1 Mental Illness Research Education and Clinical Center , West Haven, CT, USA.|4 Department of Psychiatry, Yale University School of Medicine , New Haven, CT, USA.
authors.forename: Rani A
authors.initials: RA
authors.lastname: Hoff
authors.affiliation: 1 Yale Child Study Center, Yale University School of Medicine , New Haven, CT, USA.|4 Department of Psychiatry, Yale University School of Medicine , New Haven, CT, USA.|6 Department of Neuroscience and the National Center on Addiction and Substance Abuse (CASAColumbia), Yale University School of Medicine , New Haven, CT, USA.|7 Connecticut Mental Health Center, Yale University School of Medicine , New Haven, CT, USA.
authors.forename: Marc N
authors.initials: MN
authors.lastname: Potenza
mesh_terms: D000293:Adolescent; D000328:Adult; D019973:Alcohol-Related Disorders / Q000150:complications / Q000453:epidemiology; D005260:Female; D005715:Gambling / Q000150:complications / Q000453:epidemiology* / Q000523:psychology*; D006801:Humans; D007182:Income / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: NESARC; income; problem gambling; psychiatric disorders; psychopathology