Sex differences in subclinical and DSM-IV pathological gambling: results from the National Epidemiologic Survey on Alcohol and Related Conditions
Abstract
Background. To examine sex differences in DSM-IV subclinical and pathological gambling in nationally representative data of the US population. Method. Data come from a large (n=43093) representative sample of the adult US population. Results. The lifetime prevalence rate of DSM-IV pathological gambling was 0·64% (95% CI 0·50–0·78) for men and 0·23% (95% CI 0·17–0·29) for women, whereas the lifetime prevalence of subclinical pathological gambling was 6·79% (95% CI 6·32–7·26) for men and 3·26% (95% CI 2·93–3·59) for women. For subclinical pathological gambling, men were significantly (p<0·01) more likely than women to have smoked more than two packs of cigarettes a day, to be classified as heavy drinkers and to have lifetime diagnoses of alcohol and drug use disorders. Women with subclinical and pathological gambling were significantly more likely than men to have lifetime mood and anxiety disorders. With respect to pathological gambling, women had later ages of onset of the disorder, and were significantly more likely than men to report gambling to relieve depressed mood and to prefer casino gambling. Rates of treatment-seeking for DSM-IV pathological gambling were low for both men and women. Conclusions. There are important sex differences in the prevalence, symptom pattern, sociodemographic and clinical correlates and course of DSM-IV subclinical and pathological gambling. Results underscore the need to investigate sex differences in the social determinants, neurobiology and treatment response of DSM-IV subclinical and pathological gambling.
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The lifetime prevalence of anxiety disorders in females with clinical gambling involvement (61.93%) is much greater than that observed for women in the general population (30%).
“Additionally, the lifetime prevalence of anxiety disorders in females with clinical gambling involvement (61.93%) is much greater than that observed for women in the general population (30%) (Blanco, Hasin, Petry, Stinson, & Grant, 2006; J. E. Grant et al., 2006; Kessler et al., 2005).”
From Cued for Risk: Evidence for an Incentive Sensitization Framework to Explain the Interplay between Stress and Anxiety, Substance Abuse, and Reward Uncertainty in Disordered Gambling Behavior (2019) · cites this paper as Blanco, Hasin, Petry, Stinson, & Grant, 2006
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Problem gambling and gaming in elite athletes
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“, 2017), and clear differences in the general population prevalence have been seen (Blanco et al., 2006; Ekholm et al., 2014; Husky et al., 2015; Sherba and Martt, 2015), with the prevalence among men being around three times”
BackgroundGrant, J. E., Desai, R. A., & Potenza, M. N. (2009) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.08m04211 · Cited by 50 · see citing works
Community Treatment for Problem Gambling: Sex Differences in Outcome and Process
Toneatto, T., & Wang, J. (2009) · Community mental health journal · doi:10.1007/s10597-009-9244-1 · Cited by 43 · see citing works
“Furthermore, Blanco et al. (2006) also found women pathological gamblers to be more likely to report gambling as a form of alleviation from depression compared to men.”
BackgroundExcessive Gambling and Online Gambling Communities
Sirola, A., Kaakinen, M., & Oksanen, A. (2018) · Journal of Gambling Studies · doi:10.1007/s10899-018-9772-0 · Cited by 50 · see citing works
Carbonneau, R., Vitaro, F., Brendgen, M. R., & Tremblay, R. E. (2015) · Addiction · doi:10.1111/add.13083 · Cited by 48 · see citing works
Rates and Correlates of Pathological Gambling Among VA Mental Health Service Users
Edens, E. L., & Rosenheck, R. A. (2011) · Journal of Gambling Studies · doi:10.1007/s10899-011-9239-z · Cited by 48 · see citing works
Liu, T. C., Maciejewski, P., & Potenza, M. (2008) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2008.09.011 · Cited by 51 · see citing works
Fröberg, F., Rosendahl, I. K., Abbott, M., Romild, U. K., Tengström, A., & Hallqvist, J. (2014) · Journal of Gambling Studies · doi:10.1007/s10899-014-9450-9 · Cited by 47 · see citing works
Gender Differences in Gambling Exposure and At-risk Gambling Behavior
Carneiro, E. C., Tavares, H., Sanches, M., et al. (2019) · Journal of Gambling Studies · doi:10.1007/s10899-019-09884-7 · Cited by 47 · see citing works
Loo, J. M. Y., Kraus, S. W., & Potenza, M. N. (2019) · Journal of Behavioral Addictions · doi:10.1556/2006.8.2019.64 · Cited by 49 · see citing works
“Other designations such as low-risk and at-risk gambling have been used and defined in the context of NESARC data, with designations relating to numbers of inclusionary criteria for pathological gambling acknowledged (Desai & Potenza, 2008).”
BackgroundMethodInfluentialPilver, C. E., Libby, D. J., Hoff, R. A., & Potenza, M. N. (2013) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2013.05.002 · Cited by 46 · see citing works
“Gender-related differences extend to pathological gambling (PG), with stronger links to substance-use disorders observed in women and women more likely to report negative reinforcement motivations for gambling (American Psychiatric Association, 2000; Blanco et al., 2006; Grant and Kim, 2002).”
BackgroundInfluentialGender Differences in Problem Gamblers in an Online Gambling Setting
Håkansson, A., & Widinghoff, C. (2020) · Psychology Research and Behavior Management · doi:10.2147/prbm.s248540 · Cited by 46 · see citing works
Differences in problem and pathological gambling: A narrative review considering sex and gender
Gartner, C., Bickl, A. M., Härtl, S., Loy, J. K., & Häffner, L. (2022) · Journal of Behavioral Addictions · doi:10.1556/2006.2022.00019 · Cited by 47 · see citing works
“Mean age (SD, age range) Sample type Problem gambling measures Lopez-Gonzalez et al. (2020) Australia/Spain 1,092 Australian Male: 79.3%, Female: 20.7% Spain Male: 72.0%, Female: 28.0% Adults General population PGSI Nong et al. (2020) China 855 Male: 48.1% Female: 51.9% Adults, Older Adults latent class analysis DSM-5…”
BackgroundInfluentialBae, S., Han, D. H., Jung, J., Nam, K., & Renshaw, P. F. (2017) · Journal of Behavioral Addictions · doi:10.1556/2006.6.2017.061 · Cited by 43 · see citing works
Hunt, A., Merola, G. P., Carpenter, T., & Jaeggi, A. V. (2024) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2024.105603 · Cited by 43 · see citing works
“Prob-lem gambling is associated with being young and male (at an approximately 2:1 male to female ratio; Blanco et al., 2006), typically beginning during the mid-20 s and persisting for an average of 9.4 years (Kessler et al., 2008).”
BackgroundInfluentialGambling disorder: an integrative review of animal and human studies
Nautiyal, K. M., Okuda, M., Hen, R., & Blanco, C. (2017) · Annals of the New York Academy of Sciences · doi:10.1111/nyas.13356 · Cited by 34 · see citing works
Self-citationPrevalence of suicide attempts in pathological gamblers in a nationwide Austrian treatment sample
Thon, N., Preuss, U. W., Pölzleitner, A., Quantschnig, B., Scholz, H., Kühberger, A., Bischof, A., Rumpf, H., & Wurst, F. (2014) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2014.01.012 · Cited by 38 · see citing works
“1% [2,3], and”
Gender Differences in Treatment-Seeking British Pathological Gamblers
Ronzitti, S., Lutri, V., Smith, N. T., Clerici, M., & Bowden‐Jones, H. (2016) · Journal of Behavioral Addictions · doi:10.1556/2006.5.2016.032 · Cited by 38 · see citing works
“Prevalence rates of GD among females were found to be less than half, when compared to males (Blanco, Hasin, Petry, Stinson, & Grant, 2006); however, fi gures on female problematic gambling are currently increasing as changes in the gambling market, i.e., the availability of online, more “ tailored,…”
ResultAssanangkornchai, S., McNeil, E. B., Tantirangsee, N., Kittirattanapaiboon, P., & _, _. (2016) · Journal of Behavioral Addictions · doi:10.1556/2006.5.2016.066 · Cited by 38 · see citing works
Age at onset of DSM-IV pathological gambling in a non-treatment sample: Early- versus later-onset
Black, D. W., Shaw, M. C., Coryell, W. H., Crowe, R., McCormick, B. A., & Allen, J. (2015) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2015.04.007 · Cited by 38 · see citing works
Wang, L., Zheng, H., Wang, M., Chen, S., Du, X., & Dong, G. (2022) · Journal of Behavioral Addictions · doi:10.1556/2006.2022.00057 · Cited by 35 · see citing works
Amstadter, A. B., MacPherson, L., Wang, F. M., Banducci, A. N., Reynolds, E. K., Potenza, M. N., Gelernter, J. E., & Lejuez, C. W. (2012) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2012.04.010 · Cited by 40 · see citing works
“For example, depression is more closely related to problematic gambling behaviors in women than in men (Desai & Potenza, 2008) and women with pathological gambling are more likely to acknowledge gambling to escape from negative affective states than are men (Blanco et al., 2006).”
Background
- Authors
- BLANCO, C., HASIN, D. S., PETRY, N., STINSON, F. S., & GRANT, B. F.
- Affiliations
- New York State Psychiatric Institute (US)
- UConn Health (US)
- National Institutes of Health (US)
- Venue
- Psychological Medicine
- Publisher
- Cambridge University Press (CUP)
- Published
- 2006-05-02
- Volume
- 36
- Issue
- 7
- Pages
- 943-953
- ISSN
- 0033-2917 (ISSN-L)
- 1469-8978
- OpenAlex
- W1992338801
- Cited by
- 297
- References
- 0
- Citations by year
- 2026: 2 · 2025: 6 · 2024: 7 · 2023: 20 · 2022: 13 · 2021: 12 · 2020: 12 · 2019: 22 · 2018: 14 · 2017: 15 · 2016: 15 · 2015: 26 · 2014: 25 · 2013: 25 · 2012: 19
- FWCI
- 10.71
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychological Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Alliance for Research on Schizophrenia and Depression
- National Institutes of Health (5p50aa003510-27)
- National Institute on Alcohol Abuse and Alcoholism (K05AA014223, P50- AA03510)
- National Institute of Mental Health (R01MH060417, R01 MH60417)
- National Institute on Drug Abuse (R01DA014618, R03-5R03DA15559, K23-DA00482, R01-DA14618, R01-DA13444, P50DA009241, R01DA016855, K23DA000482, P50-DA-0-9241, R01DA013444, R03DA015559)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Gambling Behavior and Treatments
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Social Sciences › Psychology › Clinical Psychology › Obsessive-Compulsive Spectrum Disorders
- Keywords
- gambling addiction, sex differences, prevalence, DSM-IV diagnostic criteria, mood disorders, anxiety disorders, alcoholism, drug use disorders, heavy drinking, cigarette smoking, age of onset, treatment seeking, casino gambling, NESARC
- MeSH terms
- Adolescent, Adult, Aged, Alcoholism, Demography, Female, Gambling, Humans, Disruptive, Impulse Control, and Conduct Disorders, Interviews as Topic, Male, Middle Aged, National Institutes of Health (U.S.), Sex Characteristics, Tobacco Use Disorder, United States, Prevalence
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