title: Gambling in a National U.S. Veteran Population: Prevalence, Socio-demographics, and Psychiatric Comorbidities.
abstract: This study aimed to examine associations between gambling level and clinically relevant measures, including psychiatric disorders and suicidality, in a nationally representative sample of U.S. veterans. Data on 3157 U.S. veterans were analyzed from the National Health and Resilience in Veterans Study. Chi square tests and analyses of variance were used to assess associations between gambling level, and demographic, military, and personality characteristics. Multinomial logistic regressions using stepwise selection were used to identify independent correlates of recreational gambling and at-risk/problem gambling (ARPG). A significant proportion of U.S. veterans engage in gambling activities, with 35.1% gambling recreationally and 2.2% screening positive for ARPG. ARPG was associated with greater prevalence of substance use, anxiety, and depressive disorders, as well as with a history of physical trauma or sexual trauma, having sought mental health treatment (particularly from the Veterans Administration), and minority group status. A similar pattern was found associated with recreational gambling, although the magnitudes of association were lower relative to ARPG. Younger age, self-identifying as black, being retired, and trauma burden were associated with increased odds of ARPG, whereas older age, being single, non-white Hispanic, being retired or not having a job, screening positive for alcohol- and drug-use disorders, and trauma burden were associated with increased odds of recreational gambling. More than a third of U.S. veterans gamble recreationally, with a significant minority (2.2%) screening positive for ARPG. Both recreational and ARPG were associated with elevated trauma burden and psychiatric comorbidities. These findings underscore the importance of routine screening and monitoring of gambling severity, and interventions for ARPG in this population.
authors.affiliation: Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA. elina.stefanovics@yale.edu.|U.S. Department of Veterans Affairs New England Mental Illness, Research, and Education Clinical Center (MIRECC), VA Connecticut Healthcare System (116A-4), 950 Campbell AvenueBuilding 36, West Haven, CT, 06516, USA. elina.stefanovics@yale.edu.
authors.forename: Elina A
authors.initials: EA
authors.lastname: Stefanovics
authors.affiliation: Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.|Department of Neuroscience and Child Study Center, Yale University School of Medicine, New Haven, CT, USA.|National Center on Addiction and Substance Abuse, Yale University School of Medicine, New Haven, CT, USA.|Connecticut Mental Health Center, New Haven, CT, USA.|Center of Excellence in Gambling Research, Yale Program for Research on Impulsivity and Impulse Control Disorders, Yale University School of Medicine, New Haven, CT, USA.
authors.forename: Marc N
authors.initials: MN
authors.lastname: Potenza
authors.affiliation: Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.|U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, USA.
authors.forename: Robert H
authors.initials: RH
authors.lastname: Pietrzak
mesh_terms: D000328:Adult; D000368:Aged; D001007:Anxiety / Q000523:psychology*; D016739:Behavior, Addictive / Q000523:psychology*; D015897:Comorbidity; D005260:Female; D005715:Gambling / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D057566:Self Report; D012720:Severity of Illness Index; D019966:Substance-Related Disorders / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014728:Veterans / Q000523:psychology*
keywords: Pathological gambling; Psychiatric disorders; Recreational gambling; Substance abuse disorders; Veterans