Yale School of Medicine, 300 George Street, New Haven, CT 06511, USA; VA Connecticut Healthcare System, 950 Campbell Avenue, West Haven, CT, USA.
VISN 1 New England MIRECC, Edith Nourse Rogers Memorial Veterans Hospital, 200 Spring Road, Building 5, Room 135B, Bedford, MA 01730, USA.
Psychiatry Res. 2018 Jan;259:254-261. doi: 10.1016/j.psychres.2017.10.028. Epub 2017 Oct 22.
The purpose of this study was to examine the extent to which stress moderated the relationships between problem-gambling severity and psychopathologies. We analyzed Wave-1 data from 41,869 participants of the National Epidemiologic Survey of Alcohol and Related Conditions (NESARC). Logistic regression showed that as compared to a non-gambling (NG) group, individuals at-risk gambling (ARG) and problem gambling (PPG) demonstrated higher odds of multiple Axis-I and Axis-II disorders in both high- and low-stress groups. Interactions odds ratios were statistically significant for stress moderating the relationships between at-risk gambling (versus non-gambling) and Any Axis-I and Any Axis-II disorder, with substance-use and Cluster-A and Cluster-B disorders contributing significantly. Some similar patterns were observed for pathological gambling (versus non-gambling), with stress moderating relationships with Cluster-B disorders. In all cases, a stronger relationship was observed between problem-gambling severity and psychopathology in the low-stress versus high-stress groups. The findings suggest that perceived stress accounts for some of the variance in the relationship between problem-gambling severity and specific forms of psychopathology, particularly with respect to lower intensity, subsyndromal levels of gambling. Findings suggest that stress may be particularly important to consider in the relationships between problem-gambling severity and substance use and Cluster-B disorders.
本研究旨在探讨压力在多大程度上调节了赌博严重程度与精神病理之间的关系。我们分析了来自国家酒精相关条件流行病学调查(NESARC)的 41869 名参与者的第 1 波数据。逻辑回归显示,与非赌博者(NG)相比,高压力和低压力组中,有风险赌博者(ARG)和问题赌博者(PPG)都表现出多种轴 I 和轴 II 障碍的更高几率。压力调节有风险赌博(与非赌博)与任何轴 I 和任何轴 II 障碍之间的关系的交互优势比具有统计学意义,物质使用和 A 类和 B 类障碍有显著贡献。对于病理性赌博(与非赌博),也观察到了类似的模式,压力调节与 B 类障碍的关系。在所有情况下,与高压力组相比,低压力组中赌博严重程度与精神病理之间的关系更强。研究结果表明,感知到的压力解释了赌博严重程度与特定形式的精神病理之间关系的一些差异,特别是在低强度、亚综合征水平的赌博方面。研究结果表明,在赌博严重程度与物质使用和 B 类障碍之间的关系中,压力可能尤其重要。