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BACKGROUND/RATIONALE:
Lifetime prevalence rates of Pathological Gambling (PG) among veterans seeking mental health care appear excessively high, ranging around 10% in two VA clinical studies. Lifetime prevalence of one or more gambling problems among veterans seeking mental health care was also high at 40% in one study. In addition, unrecognized PG and gambling problems undermine treatment of other disorders.
Our community survey of American Indian and Hispanic veterans showed lifetime PG rates of 10% and 7% respectively.
These alarming rates have occurred over the last two decades in association with legalized gambling, now present in 47 of 50 states. Trauma has also been associated with PG and problem gambling. Full-blown PG has proven a major, costly clinical challenge, whereas screening for problem gambling and sub-diagnostic comorbid symptoms may foster early intervention.
OBJECTIVE(S):
Rationales for the proposed study are as follows: (1) to assess the rates of PG and gambling problems among veterans receiving VA care in order to plan and implement interventions in VA settings; (2) to assess comorbid rates with the common psychiatric disorder, to determine needed services in VA mental health care settings; and (3) to assess whether particular demographic or clinical risk factors exist, so that (a) veterans can assess their own risk and (b) screening of veterans can be targeted to reach those at greatest risk to PG.
We will characterize the nature and extent of PG and gambling problems among veterans receiving VA health care, as a first step toward effective screening and intervention to prevent PG. Specific aims involve: (1) determining the prevalence rates of PG problem gambling among veterans-in-VA-care and (2) establishing the nature and extent of psychiatric problems comorbid with PG and gambling problems.
METHODS:
Data will be collected from 2,400 veterans (1,600men; 800 women) who have received care in the last fiscal year at the Minneapolis and Albuquerque VAMCs and their associated CBOCs. They will be randomly selected from 110,000+ veterans. Data will include lifetime prevalence, current one-year prevalence, and incidence of PG and problem gambling. Pathological Gambling (PG) diagnoses are based on DSM-IV criteria.
The Diagnostic Interview Schedule/Computerized version will provide comorbid diagnosis, both lifetime and current 1-year diagnoses. Self-rated anxiety-depression, posttraumatic, and alcohol-drug scales will provide information regarding sub-diagnostic gambling problems.
FINDINGS/RESULTS:
No findings at this time.
Data collection in progress.
IMPACT:
The impact is to reduce the prevalence of gambling problems and Pathological Gambling among veterans nationally.
PUBLICATIONS:
None at this time.
DRA:
Mental Illness, Substance Abuse, Addictive Disorders
DRE:
none
Keywords:
Behavior (patient)
MeSH Terms:
none
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