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Prevalence and Clinical Characteristics of Recreational and At-Risk/Problematic Gambling in a National Sample of U.S. Military Veterans

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Abstract

Gambling among U.S. military veterans is common, with more extensive involvement linked to gambling disorder and associated problems. This study examined associations between recreational gambling (RG) and at-risk/problem gambling (ARPG), and clinical measures (psychiatric disorders, substance use), behaviors (suicidality, homelessness, arrests) and functioning in a nationally representative sample of U.S. military veterans. Data were analyzed from 4069 veterans who participated in the National Health and Resilience in Veterans Study. Chi-square tests, analyses of variance (ANOVAs) and logistic regressions were conducted to examine unadjusted and adjusted associations between gambling group status and lifetime and current psychiatric diagnoses and behavioral and functioning measures. A significant minority of U.S. veterans reported gambling, with 27.3% (95% confidence interval [CI] 25.5–29.1%) exhibiting RG and 4.9% (95% CI 4.0–5.9%) screening positive for ARPG. The prevalence of ARPG was higher among younger, non-White, male veterans, while RG was more prevalent among retired veterans and those with higher household incomes relative to non-gambling (NG) individuals. ARPG was associated with greater trauma burden, lifetime and current psychiatric diagnoses, mental health treatment, alcohol and drug use disorders, suicidal ideation, homelessness, arrests, and poorer functioning relative to NG and RG, with stronger magnitude differences relative to NG. RG was associated with substance use disorders and arrest histories relative to NG. Results of the current study provide an up-to-date estimate of the current prevalence of RG and ARPG among U.S. veterans and underscore the importance of routine screening and monitoring of gambling problems, as well as interventions for ARPG in this population.

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Funding

This work was supported by the VA National Center for PTSD. Dr. Stefanovics was supported by the Connecticut Council on Problem Gambling and National Center for Homelessness for Veterans (NCHV). Dr. Potenza was supported by the Connecticut Council on Problem Gambling. Dr. Tsai was supported by the National Center for Homelessness for Veterans (NCHV). Dr. Pietrzak was supported by the VA National Center for PTSD.

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Authors and Affiliations

  1. Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA

    Elina A. Stefanovics, Marc N. Potenza, Jack Tsai & Robert H. Pietrzak

  2. U.S. Department of Veterans Affairs New England Mental Illness Research and Education Clinical Center (MIRECC), VA Connecticut Healthcare System (116A-4), 950 Campbell Avenue, Building 36, West Haven, CT, 06516, USA

    Elina A. Stefanovics

  3. U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, USA

    Robert H. Pietrzak

  4. National Center on Homelessness Among Veterans, U.S. Department of Veterans Affairs, Tampa, FL, USA

    Jack Tsai

  5. Department of Management, Policy, and Community Health, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, USA

    Jack Tsai

  6. Yale Child Study Center, Yale University, New Haven, CT, USA

    Marc N. Potenza

  7. Connecticut Mental Health Center, New Haven, CT, USA

    Marc N. Potenza

  8. Connecticut Council on Problem Gambling, Wethersfield, CT, USA

    Marc N. Potenza

  9. Department of Neuroscience, Yale University, New Haven, CT, USA

    Marc N. Potenza

  10. Wu Tsai Institute, Yale University, New Haven, CT, USA

    Marc N. Potenza

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  1. Elina A. Stefanovics
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Correspondence to Elina A. Stefanovics.

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The authors have no conflict of interest to report. MNP discloses the following. MNP has consulted for Opiant Therapeutics, Game Day Data, the Addiction Policy Forum, AXA and Idorsia Pharmaceuticals; has been involved in a patent application with Yale University and Novartis; has received research support from Mohegan Sun Casino, the Connecticut Council on Problem Gambling and the National Center for Responsible Gaming; has participated in surveys, mailings or telephone consultations related to drug addiction, impulse-control disorders or other health topics; has consulted for and/or advised gambling and legal entities on issues related to impulse-control/addictive disorders; has performed grant reviews for research-funding agencies; has edited journals and journal sections; has given academic lectures in grand rounds, CME events and other clinical or scientific venues; and has generated books or book chapters for publishers of mental health texts.

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Stefanovics, E.A., Potenza, M.N., Tsai, J. et al. Prevalence and Clinical Characteristics of Recreational and At-Risk/Problematic Gambling in a National Sample of U.S. Military Veterans. J Gambl Stud 39, 1077–1097 (2023). https://doi.org/10.1007/s10899-022-10165-z

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