Cited by 928Gambling Behavior and TreatmentsSubstance Abuse Treatment and OutcomesPersonality Disorders and Psychopathology

DSM-IV pathological gambling in the National Comorbidity Survey Replication

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Kessler, R. C., Hwang, I., LaBrie, R., Petukhova, M., Sampson, N. A., Winters, K. C., Shaffer, H. J.·2008·Psychological Medicine

Abstract

Background: Little is known about the prevalence or correlates of DSM-IV pathological gambling (PG). Method: Data from the US National Comorbidity Survey Replication (NCS-R), a nationally representative US household survey, were used to assess lifetime gambling symptoms and PG along with other DSM-IV disorders. Age of onset (AOO) of each lifetime disorder was assessed retrospectively. AOO reports were used to study associations between temporally primary disorders and the subsequent risk of secondary disorders. Results: Most respondents (78.4%) reported lifetime gambling. Lifetime problem gambling (at least one Criterion A symptom of PG) (2.3%) and PG (0.6%) were much less common. PG was significantly associated with being young, male, and Non-Hispanic Black. People with PG reported first gambling significantly earlier than non-problem gamblers (mean age 16.7 v . 23.9 years, z =12.7, p <0.001), with gambling problems typically beginning during the mid-20s and persisting for an average of 9.4 years. During this time the largest annual gambling losses averaged US$4800. Onset and persistence of PG were predicted by a variety of prior DSM-IV anxiety, mood, impulse-control and substance use disorders. PG also predicted the subsequent onset of generalized anxiety disorder, post-traumatic stress disorder (PTSD) and substance dependence. Although none of the NCS-R respondents with PG ever received treatment for gambling problems, 49.0% were treated at some time for other mental disorders. Conclusions: DSM-IV PG is a comparatively rare, seriously impairing, and undertreated disorder whose symptoms typically start during early adulthood and is frequently secondary to other mental or substance disorders that are associated with both PG onset and persistence.

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Authors
Kessler, R. C., Hwang, I., LaBrie, R., Petukhova, M., Sampson, N. A., Winters, K. C., & Shaffer, H. J.
Affiliations
  • Harvard University (US)
  • Cambridge Health Alliance (US)
  • University of Minnesota (US)
Corresponding author
Kessler, R. C.
Venue
Psychological Medicine
Published
2008-02-07
Volume
38
Issue
9
Pages
1351-1360
ISSN
  • 0033-2917 (ISSN-L)
  • 1469-8978
OpenAlex
W2121784510
Cited by
928
References
29
Citations by year
2026: 26 · 2025: 27 · 2024: 28 · 2023: 34 · 2022: 40 · 2021: 49 · 2020: 89 · 2019: 76 · 2018: 67 · 2017: 51 · 2016: 66 · 2015: 62 · 2014: 75 · 2013: 64 · 2012: 65
FWCI
40.15
Type
journal article
Language
en
Open access
Locations
  • Psychological Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • Robert Wood Johnson Foundation
  • John D. and Catherine T. MacArthur Foundation
  • John W. Alden Trust
  • World Health Organization
  • National Institutes of Health (5r13mh066849-04, 5r01mh069864-04, 5r01mh070884-05)
  • Substance Abuse and Mental Health Services Administration
  • Johnson and Johnson
  • Pan American Health Organization
  • National Institute of Mental Health (R13-MH-066849, R01‐MH070884, U01-MH-60220, U13MH066849, U01MH060220, R01‐MH069864)
  • National Institute on Drug Abuse (K05DA015799, R01DA016558)
  • Fogarty International Center (R01-TW006481, R03TW006481)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Gambling Behavior and Treatments
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
  • Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
Keywords
gambling addiction, problem gambling, prevalence, age of onset, comorbidities, anxiety disorders, mood disorders, impulse control disorders, substance use disorders, generalized anxiety disorder, post-traumatic stress disorder, substance dependence, gambling losses, treatment utilization, DSM-IV diagnostic criteria
MeSH terms
Adolescent, Adult, Mental Disorders, Data Collection, Ethnicity, Female, Gambling, Humans, Disruptive, Impulse Control, and Conduct Disorders, Male, Predictive Value of Tests, Retrospective Studies, Socioeconomic Factors, United States, Comorbidity, Prevalence, Odds Ratio, Age of Onset, Age Distribution, Sex Distribution, Diagnostic and Statistical Manual of Mental Disorders

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