Stefanovics Elina A, Potenza Marc N, Pietrzak Robert H
Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.
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.
J Gambl Stud. 2017 Dec;33(4):1099-1120. doi: 10.1007/s10899-017-9678-2.
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.
本研究旨在在美国退伍军人的全国代表性样本中，考察赌博水平与包括精神障碍和自杀倾向在内的临床相关指标之间的关联。对来自退伍军人健康与复原力研究的3157名美国退伍军人的数据进行了分析。采用卡方检验和方差分析来评估赌博水平与人口统计学、军事和人格特征之间的关联。使用逐步选择法的多项逻辑回归用于确定娱乐性赌博和高危/问题赌博（ARPG）的独立相关因素。相当比例的美国退伍军人参与赌博活动，其中35.1%进行娱乐性赌博，2.2%的ARPG筛查呈阳性。ARPG与物质使用、焦虑和抑郁障碍的患病率较高有关，也与身体创伤或性创伤史、寻求心理健康治疗（特别是向退伍军人管理局寻求治疗）以及少数群体身份有关。娱乐性赌博也发现了类似的模式，尽管关联程度相对于ARPG较低。年龄较小、自我认定为黑人、已退休以及创伤负担与ARPG几率增加有关，而年龄较大、单身、非白人西班牙裔、已退休或无工作、酒精和药物使用障碍筛查呈阳性以及创伤负担与娱乐性赌博几率增加有关。超过三分之一的美国退伍军人进行娱乐性赌博，少数（2.2%）的ARPG筛查呈阳性。娱乐性赌博和ARPG都与创伤负担加重和精神共病有关。这些发现强调了对赌博严重程度进行常规筛查和监测以及对该人群中的ARPG进行干预的重要性。
