Problem Gambling and Homelessness: Results from an Epidemiologic Study
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The purpose of this study was to investigate the prevalence of gambling disorder and comorbid psychiatric disorders in a homeless population and identify features related to potential subtypes. At baseline, participants were administered a structured interview including socio-demographic sections of the National Comorbidity Study (NCS) interview; seven diagnostic sections of the Diagnostic Interview Schedule (DIS); the alcohol and drug abuse sections of the Composite International Diagnostic Interview—Substance Abuse Module (CIDI-SAM); and the Homeless Supplement to the DIS. At nine months post-baseline assessment, participants were administered additional NCS family history questions and the South Oaks Gambling Screen (SOGS). Participants were an epidemiologic sample of 275 predominately African-American homeless individuals, grouped as lifetime non-gamblers (n = 60), recreational gamblers (n = 152), and problem gamblers (n = 63), recruited on the street and through homeless shelters. Results indicate that lifetime rates of sub-clinical problem (46.2 %) and disordered (12.0 %) gambling were significantly higher than in the general population. Problem gamblers were more likely than non-problem gamblers to meet diagnostic criteria for antisocial personality disorder, post-traumatic stress disorder, bipolar disorder, and any psychiatric disorder, and more likely than non-gamblers to use illicit drugs or meet criteria for abuse/dependence for nicotine, alcohol, or any substance. This study provides evidence that problem gambling is a significant public health issue among the African-American homeless population. Homeless services should include assessment for problem gambling along with psychiatric disorders and referrals to resources and treatment programs. Future studies should explore the relationship of the onset and course of problem gambling and other psychiatric disorders with homelessness as well as racial differences in gambling patterns and problem severity over time.
KeywordsHomelessness Problem gambling Gambling disorder Substance abuse Psychiatric disorders African American
This work was supported by the National Institute on Drug Abuse (NIDA) Grant #10713 to Dr. North and the Ontario Problem Gambling Research Centre grant to Dr. Nower.
- American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed text rev. Washington DC: APA; 2013.Google Scholar
- Cottler, L. B., & Compton, W. C. (1993). Advantages of the CIDI family of instruments in epidemiological research of substance use disorders. International Journal of Methods in Psychiatric Research, 3, 109–119.Google Scholar
- Cunningham-Williams, R. M., Cottler, L. B., Compton, W. M., & Spitznagel, E. L. (1998). Taking chances: problem gamblers and mental health disorders—results from the St. Louis Epidemiologic Catchment Area Study. American Journal of Public Health, 88, 1093–1096.CrossRefPubMedCentralPubMedGoogle Scholar
- Gerstein, D. R., Volberg, R. A., Harwood, H., Christiansen, E. M., et al. (1999). Gambling impact and behavior study: Report to the National Gambling Impact Study Commission. Chicago, IL: National Opinion Research Center at the University of Chicago.Google Scholar
- Heffron, W. A., Skipper, B. J., & Lambert, L. (1997). Health and lifestyle issues as risk factors for homelessness. Journal of the American Board of Family Practice, 10, 67–71.Google Scholar
- International Union of Gospel Missions. (1998). Gambling and homelessness survey. Kansas City, MO: International Union of Gospel Missions, Association of Gospel Rescue Missions.Google Scholar
- Kessler, R. C., Hwang, I., LaBrie, R., Petukhova, M., Sampson, N. A., Winters, K. C., et al. (2008). The prevalence and correlates of DSM-IV pathological gambling in the National Comorbidity Survey Replication. Psychological Medicine, 38, 1351–1360.Google Scholar
- Kessler, R. C., McGonagle, K. A., Zhao, S., Nelson, C. B., Highes, M., Eshleman, S., et al. (1994). Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States: results from the National Comorbidity Survey. Archives of General Psychiatry, 51, 8–19.CrossRefPubMedGoogle Scholar
- National Research Council. (1999). Pathological gambling: A critical review. Washington, DC: National Academy Press.Google Scholar
- Reardon, M. L., Burns, A. B., Preist, R., Sachs-Ericsson, N., & Lang, A. R. (2003). Alcohol use and other psychiatric disorders in the formerly homeless and never homeless: Prevalence, age of onset, comorbidity, temporal sequencing and service utilization. Substance Use and Misuse, 38, 601–645.CrossRefPubMedGoogle Scholar
- Robins, L. N., Cottler, L. B., Compton, W. C., Bucholz, K., North, C. S., & Roarke, K. (1998). Diagnostic interview schedule, Version 4.2. St. Louis: Washington University.Google Scholar
- U.S. Bureau of the Census (2011). Age and sex composition in the United States: 2011. Retrieved from: http://www.census.gov/population/age/data/2011comp.html.
- Williams, R.J., Volberg, R.A. & Stevens, R.M.G. (2012). The Population Prevalence of Problem Gambling: Methodological Influences, Standardized Rates, Jurisdictional Differences, and Worldwide Trends. Report prepared for the Ontario Problem Gambling Research Centre and the Ontario Ministry of Health and Long Term Care. May 8. Retrieved from: https://www.uleth.ca/dspace/bitstream/handle/10133/3068/2012-PREVALENCE-OPGRC%20%282%29.pdf?sequence=3.