The DOI matches its Crossref record; 30 of the 30 references it cites were found in a registry or an index.
DSM-IV pathological gambling in the National Comorbidity Survey Replication
Open accessAbstract
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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In the citing paper
“Epidemiological research indicates that over 50% of PGs have a lifetime mood disorder, over 40% have a lifetime anxiety disorder, and about 23% have ASPD (Kessler et al. 2008; Petry, Stinson & Grant, 2005).”
From Subtyping Pathological Gamblers Based on Impulsivity, Depression, and Anxiety (2010) · cites this paper as Kessler et al. 2008
Experimental — accuracy not yet measuredIn the citing paper
“Gambling disorder often co-occurs with psychiatric disorders, particularly substance use and anxiety disorders (el-Guebaly et al., 2006; Kessler et al., 2008; Lorains, Cowlishaw, & Thomas, 2011; Parhami, Mojtabai, Rosenthal, Afifi, & Fong, 2014).”
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 Kessler et al., 2008
In the citing paper
“For gambling disorder and substance use disorders, it appears this relationship is bi-directional, as the presence of one of either of these conditions often predicts the onset of the other (Afifi, Nicholson, Martins, & Sareen, 2016; Kessler et al., 2008).”
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 Kessler et al., 2008
In the citing paper
“Approximately 37% (range: 14.0% −60.3%) of subthreshold and clinical gamblers suffer from an anxiety disorder (Kessler et al., 2008; Lorains et al., 2011; Petry 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 Kessler et al., 2008
In the citing paper
“Anxiety disorders, however, often precede the onset of gambling disorder or substance use disorders (Blanco et al., 2015; Kausch, Rugle, & Rowland, 2006; Kessler et al., 2008).”
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 Kessler et al., 2008
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Citations
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Cited by
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“…that epidemiological studies estimate 96% of people with GD have at least one other psychiatric disorder, with impulse-control disorders, substance use disorder (SUD), mood disorders and anxiety disorders particularly common among people with GD (Kessler et al., 2008; Potenza et al., 2019).”
UPPS-P Impulsivity, Momentary Affect, and Gambling: an Experience Sampling Method Study
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Haznedaroğlu, D. İ., Görkem, O., & Değirmenci, Ö. (2026) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2025.1723070
“In line with this, Kessler et al. (2008) reported that individuals who were neither university graduates nor students had signi fi cantly higher risk of pathological gambling in a U.S. representative sample (18).”
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“An epidemiological study conducted in the United States revealed that 96% of people with GD had at least one other psychiatric disorder, excluding psychotic disorders and personality disorders, and that 64% had three or more other mental disorders (Kessler et al. 2008).”
Carbonneau, R., Vitaro, F., Brendgen, M. R., Boivin, M., Côté, S. M., & Tremblay, R. E. (2026) · Journal of Gambling Studies · doi:10.1007/s10899-026-10512-4
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Pfund, R. A., Rodda, S. N., & Weinstock, J. (2026) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2026.05.006
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“Across contexts, men are generally at higher risk, and earlier initiation of gambling is consistently associated with more severe problems in adulthood (Australian Productivity Commission, 1999 ; Kessler et al., 2008).”
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“This ambivalence has been documented in previous studies, which show that affective bonds in women with gambling disorder can function both as stabilizing forces and sources of emotion dysregulation [36, 37].”
Im, J., Silver, S., Donovan, F., Wong, A., Le, E., Goel, A., Tunikipati, A., Ruderman, B., & Fong, T. (2026) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2026.1835519
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“…temporal relationship between depression and gambling: some studies indicate that depressive symptoms may precede the onset of gambling problems (Kessler et al., 2008), whereas others suggest that depression can emerge as a consequence of gambling due to its negative psychosocial and financial…”
Díaz, M. D. L. R., Méndez, I., Ros, N. A., & Esteban, C. R. (2026) · European Journal of Investigation in Health Psychology and Education · doi:10.3390/ejihpe16090124
“…of 18 and 35 are the most commonly affected, although it can also affect older people (Calado & Griffiths, 2016), and is more common in men than women (Kessler et al., 2008), which may be due to men’s tendency to have greater impulsivity or an interest in sports betting or poker (Chóliz, 2016).”
Addictions are linked but distinct: A transdiagnostic network analysis of concurrent disorder risk
Murch, W. S., Dawson, S. J., Hodgins, D. C., Keough, M. T., McGrath, D. S., Shead, N. W., Tabri, N., & Kim, H. S. A. (2026) · Journal of Behavioral Addictions · doi:10.1556/2006.2026.00050
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“Previous studies have reported substantial psychiatric comorbidity among individuals with pathological gambling, including associations with substance-related, mood, and personality disorders [22– 24].”
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Metadata
- 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
- Publisher
- Cambridge University Press (CUP)
- Published
- 2008-02-07
- Volume
- 38
- Issue
- 9
- Pages
- 1351-1360
- ISSN
- 0033-2917 (ISSN-L)
- 1469-8978
- PMC
- PMC2293303
- 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
- green
- www.ncbi.nlm.nih.gov
- 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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