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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
Cites
Diagnostic and Statistical Manual of Mental Disorders
Williams, J. B. W., & First, M. B. (2013) · Oxford University Press eBooks · doi:10.1093/acrefore/9780199975839.013.104 · Cited by 109,845
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Self-citationDiagnostic and Statistical Manual of Mental Disorders (DSM-IV)
Hu, R. J. (2003) · Elsevier eBooks · doi:10.1016/b0-12-226870-9/01070-4 · Cited by 9,168
Kessler, R. C., & Üstün, T. B. (2004) · International Journal of Methods in Psychiatric Research · doi:10.1002/mpr.168 · Cited by 4,771
Self-citationIntroduction to Variance Estimation.
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Self-citationPetry, N. M., Stinson, F. S., & Grant, B. F. (2005) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v66n0504 · Cited by 1,245
The US National Comorbidity Survey Replication (NCS‐R): design and field procedures
Kessler, R. C., Berglund, P. A., Chiu, W. T., Demler, O., Heeringa, S. G., Hiripi, E., Jin, R., Pennell, B., Walters, E. E., Zaslavsky, A. M., et al. (2004) · International Journal of Methods in Psychiatric Research · doi:10.1002/mpr.167 · Cited by 858
Self-citationIntroduction to Variance Estimation
Hidiroglou, M. A., & Wolter, K. M. (1986) · Technometrics · doi:10.2307/1269086 · Cited by 820
The National Comorbidity Survey Replication (NCS‐R): background and aims
Kessler, R. C., & Merikangas, K. R. (2004) · International Journal of Methods in Psychiatric Research · doi:10.1002/mpr.166 · Cited by 745
Self-citation
Research works printed but not linked: 5
- 1999, Pathological Gambling: A Critical Review
- 1991, International Classification of Diseases (ICD-10)
- First, 2002, Structured Clinical Interview for DSM-IV Axis I Disorders, Research Version, Non-Patient Edition (SCID-I/NP)
- Kallick, 1979, A Survey of American Gambling Attitudes and Behavior
- 2002, SUDAAN: Professional Software for Survey Data Analysis
Cited by
Sorted by citations
DSM-5 criteria for substance use disorders: recommendations and rationale
Hasin, D. S., O’Brien, C. P., Auriacombe, M., Borges, G., Bucholz, K., Budney, A., Compton, W. M., Crowley, T., Ling, W., Petry, N. M., et al. (2013) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2013.12060782 · Cited by 1,622
Lorains, F. K., Cowlishaw, S., & Thomas, S. A. (2011) · Addiction · doi:10.1111/j.1360-0443.2010.03300.x · Cited by 1,006
Hodgins, D. C., Stea, J. N., & Grant, J. E. (2011) · The Lancet · doi:10.1016/s0140-6736(10)62185-x · Cited by 457
Potenza, M. N., Balodis, I. M., Derevensky, J., Grant, J. E., Petry, N. M., Verdejo-Garcia, A., & Yip, S. W. (2019) · Nature Reviews Disease Primers · doi:10.1038/s41572-019-0099-7 · Cited by 437
Williams, R. J., Volberg, R. A., & Stevens, R. M. G. (2012) · Open ULeth Scholarship (OPUS) (University of Lethbridge) · Cited by 400
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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