Post-Traumatic Stress and Gambling Related Cognitions: Analyses in Inpatient and Online Samples

Grubbs, Joshua B.; Chapman, Heather; Shepherd, Kathrine A.

doi:10.1016/j.addbeh.2018.09.035

Cited by 21Gambling Behavior and TreatmentsPosttraumatic Stress Disorder ResearchObsessive-Compulsive Spectrum Disorders

Post-Traumatic Stress and Gambling Related Cognitions: Analyses in Inpatient and Online Samples

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Grubbs, Joshua B., Chapman, Heather, Shepherd, Kathrine A.·2019·Addictive Behaviors

DOI 10.1016/j.addbeh.2018.09.035

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Abstract

Individuals with gambling disorder (GD) report much higher rates of post-traumatic stress symptoms and post-traumatic stress disorder (PTSS/D) than the general population, and individuals with both PTSS/D and GD often report much greater distress and impairment in daily life in comparison to individuals with GD alone (Grubbs, Chapman, Milner, Gutierrez, & Bradley, 2018). Despite these associations, little is known about the specific ways in which PTSS/D and GD might influence each other. To address this gap in research, the present work sought to examine how PTSD might be related to the expression and experience of gambling related cognitions. Specifically, it was hypothesized that individuals with PTSD or symptoms of PTSD (i.e., subclinical levels of post-traumatic stress) would demonstrate greater cognitive distortions and erroneous beliefs about gambling. To test these hypotheses, we analyzed data from two samples, an inpatient sample of U.S. Armed Forces veterans seeking treatment for gambling disorder (n = 332) and an online sample of largely recreational gambling U.S. adults (n = 589). Results consistently revealed that, in both samples, individuals with PTSD or symptoms of PTSD were likely to report greater gambling related cognitions. These findings persisted, even when gambling symptom severity and trait neuroticism were held constant. Collectively, these results suggest that PTSD is uniquely associated with greater cognitive distortions and erroneous beliefs about gambling behaviors. These findings bear distinct implications for current understandings of how PTSS/D and GD are related, as well as for treatment of individuals with dealing with this comorbidity.

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Sensitization of the mesolimbic dopamine pathway, observed in both gambling and substance use disorders, underscores the significant role of stress in relapse.
“The sensitization of the mesolimbic dopamine pathway, observed in both gambling and substance use disorders, underscores the significant role of stress in relapse [88,89,90].”
From Comprehensive review of chronic stress pathways and the efficacy of behavioral stress reduction programs (BSRPs) in managing diseases. (2024) · cites this paper as [89]
Analysis of data from the National Epidemiologic Survey of Alcohol and Related Conditions, including 41,869 participants, revealed that at-risk and problem gamblers were more likely to have multiple Axis-I and Axis-II disorders than non-gamblers, with this relationship being stronger in low-stress environments.
“Analysis of data from the National Epidemiologic Survey of Alcohol and Related Conditions, which included 41,869 participants, revealed that those identified as at-risk gamblers and problem gamblers were more likely to have multiple Axis-I and Axis-II disorders than non-gamblers, with this relationship being stronger in low-stress environments.”
From Comprehensive review of chronic stress pathways and the efficacy of behavioral stress reduction programs (BSRPs) in managing diseases. (2024) · cites this paper as [89]
Individuals with gambling disorder exhibit significantly higher rates of post-traumatic stress symptoms and PTSD compared to the general population.
“Individuals with gambling disorder exhibit significantly higher rates of post-traumatic stress symptoms (PTSS) and PTSD compared to the general population.”
From Comprehensive review of chronic stress pathways and the efficacy of behavioral stress reduction programs (BSRPs) in managing diseases. (2024) · cites this paper as [89]

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Tang, R., Price, J. M., & Bonardi, C. (2026) · Learning & Behavior · doi:10.3758/s13420-026-00707-5
From trauma to tolerance: Psychological predictors of gambling harm among male UK Armed Forces Veterans
Ekenna, A., Dekel, D., Engward, H., Godier-McBard, L. R., Kay, C., Kersey, T., Fossey, M. J., & Dymond, S. (2026) · Journal of Military Veteran and Family Health · doi:10.3138/jmvfh-2025-0098

Examining Links between Post-Traumatic Stress and Gambling Motives: The Role of Positive Gambling Expectancies
Grubbs, J., Chapman, H. A., Milner, L. A., Gutierrez, I., & Bradley, D. (2018) · Open Science Framework · doi:10.17605/osf.io/zxw6d
Gambling Disorder and comorbid PTSD: A systematic review of empirical research
Moore, L. H., & Grubbs, J. B. (2020) · Addictive Behaviors · doi:10.1016/j.addbeh.2020.106713 · Cited by 51 · see citing works
Posttraumatic stress disorder symptoms in treatment-seeking pathological gamblers
Ledgerwood, D. M., & Petry, N. M. (2006) · Journal of Traumatic Stress · doi:10.1002/jts.20123 · Cited by 77 · see citing works
Predicting Gambling Situations: The Roles of Impulsivity, Substance Use, and Post-Traumatic Stress
Grubbs, J. B., & Chapman, H. A. (2019) · Substance Abuse Research and Treatment · doi:10.1177/1178221819852641 · Cited by 16 · see citing works
Gambling Disorder and Comorbid PTSD: Pathological Dissociation as a Mechanism of Clinical Severity
Moore, L. H. (2021) · ScholarWorks@BGSU (Bowling Green State University)

Authors: Grubbs, J. B., Chapman, H., & Shepherd, K. A.
Affiliations: Bowling Green State University (US)
Louis Stokes Cleveland VA Medical Center (US)
Corresponding author: Grubbs, Joshua B.
ORCID: Grubbs, Joshua B.
Chapman, Heather
Shepherd, Kathrine A.
Venue: Addictive Behaviors
Publisher: Elsevier BV
Published: 2019-02
Volume: 89
Pages: 128-135
ISSN: 0306-4603 (ISSN-L)
DOI: 10.1016/j.addbeh.2018.09.035
OpenAlex: W2894248284
Cited by: 21
References: 68
Citations by year: 2026: 2 · 2025: 3 · 2024: 3 · 2023: 2 · 2022: 4 · 2021: 3 · 2020: 3 · 2019: 1
FWCI: 2.05
Type: journal article
Language: en
Open access: green
doi.org
Licence: cc-by
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
Locations: Addictive Behaviors (publishedVersion)
PubMed (publishedVersion)
PsyArXiv (OSF Preprints) (submittedVersion, cc-by)
PsyArXiv (OSF Preprints) (submittedVersion)
OSF Preprints (OSF Preprints) (submittedVersion)
Funders: National Center for Responsible Gaming
Topics: Social Sciences › Psychology › Clinical Psychology › Gambling Behavior and Treatments
Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
Social Sciences › Psychology › Clinical Psychology › Obsessive-Compulsive Spectrum Disorders
Keywords: post-traumatic stress disorder, gambling addiction, gambling-related cognitions, cognitive distortions, comorbidities, veterans, online sample, neuroticism
MeSH terms: Adult, Cognition, Female, Gambling, Humans, Inpatients, Male, Middle Aged, Ohio, Stress Disorders, Post-Traumatic, Veterans, Comorbidity

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Post-Traumatic Stress and Gambling Related Cognitions: Analyses in Inpatient and Online Samples

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