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 Avenue, Build 36, West Haven, CT, 06516, USA.
J Gambl Stud. 2024 Dec;40(4):2119-2139. doi: 10.1007/s10899-024-10359-7. Epub 2024 Sep 29.
Gambling and substance use disorders (SUDs) are prevalent among U.S. military veterans and often co-occur. However, little is known about the clinical and behavioral correlates and suicidal risk of SUDs and gambling among veterans that can help inform targeted interventions for their co-occurrence. In the current study, we analyzed data from a nationally representative sample of 4069 veterans who participated in the National Health and Resilience in Veterans Study. Self-reported measures of lifetime SUDs and past-year gambling (Brief Problem Gambling Screen) were administered. A multinomial logistic regression analysis was conducted to examine differences between four groups: non-SUD/non-gambling, 40.3%; SUD-only 27.3%; Gambling-only 16.3%; and SUD + Gambling, 16.1%. The Gambling-only, SUD-only, and SUD + Gambling groups reported more adverse childhood experiences relative to the non-SUD/non-gambling group. The SUD-only and SUD + Gambling groups had higher odds for all lifetime and current clinical and trauma variables relative to the non-SUD/non-gambling group. The SUD + Gambling group had higher odds of suicidality, non-suicidal self-injury, nicotine dependence and mental health treatment relative to the SUD-only group and all assessed clinical measures relative to the Gambling-only group. Results suggest that SUDs and gambling are associated with substantial trauma and mental health burden among U.S. veterans, with co-occurring SUDs and gambling linked particularly to suicidality/self-harm and mental health treatment. The findings underscore the importance of multicomponent assessments and interventions targeting SUDs, gambling, and related concerns, such as trauma-related mental health difficulties, in this population.
赌博和物质使用障碍（SUD）在美国退伍军人中普遍存在，且经常同时发生。然而，人们对退伍军人中 SUD 和赌博的临床和行为相关性以及自杀风险知之甚少，这有助于为它们的同时发生提供有针对性的干预措施。在目前的研究中，我们分析了参加国家健康和退伍军人适应力研究的 4069 名退伍军人的全国代表性样本数据。进行了终生 SUD 和过去一年的赌博（简短问题赌博筛查）的自我报告措施。进行了多项逻辑回归分析，以检查四个组之间的差异：非 SUD/非赌博者，占 40.3%；SUD 仅有者，占 27.3%；赌博仅有者，占 16.3%；SUD+赌博者，占 16.1%。与非 SUD/非赌博者相比，赌博仅有者、SUD 仅有者和 SUD+赌博者报告了更多的不良童年经历。与非 SUD/非赌博者相比，SUD 仅有者和 SUD+赌博者终生和当前的临床和创伤变量的可能性更高。与 SUD 仅有者相比，SUD+赌博者自杀、非自杀性自伤、尼古丁依赖和心理健康治疗的可能性更高，与赌博仅有者相比，所有评估的临床指标也是如此。结果表明，SUD 和赌博与美国退伍军人的大量创伤和心理健康负担有关，同时发生的 SUD 和赌博与自杀/自残和心理健康治疗尤其相关。这些发现强调了对退伍军人进行多方面评估和干预的重要性，这些干预措施针对 SUD、赌博以及与创伤相关的心理健康问题等相关问题。
