DSM-based problem gambling: increasing the odds of heavy drinking in a national sample of U.S. college athletes?

J Psychiatr Res. 2011 Mar;45(3):302-8. doi: 10.1016/j.jpsychires.2010.07.001. Epub 2010 Jul 17.


Despite previously found co-occurrence of youth gambling and alcohol use, their relationship has not been systematically explored in a national sample using DSM-based gambling measures and multivariate modeling, adjusted for potential confounders. This study aimed to empirically examine the prevalence patterns and odds of at-least-weekly alcohol use and heavy episodic drinking (HED) in relation to various levels of gambling severity in college athletes. Multivariate logistic regression analyses were performed on data from a national sample of 20,739 U.S. college athletes from the first National Collegiate Athletic Association national survey of gambling and health-risk behaviors. Prevalence of at-least-weekly alcohol use significantly increased as DSM-IV-based gambling severity increased, from non-gambling (24.5%) to non-problem gambling (43.7%) to sub-clinical gambling (58.5%) to problem gambling (67.6%). Multivariate results indicated that all levels of gambling were associated with significantly elevated risk of at-least-weekly HED, from non-problem (OR = 1.25) to sub-clinical (OR = 1.75) to problem gambling (OR = 3.22); the steep increase in the relative risk also suggested a possible quadratic relationship between gambling level and HED risk. Notably, adjusted odds ratios showed problem gambling had the strongest association with at-least-weekly HED, followed by marijuana (OR = 3.08) and cigarette use (OR = 2.64). Gender interactions and differences were also identified and assessed. In conclusion, attention should be paid to college athletes exhibiting gambling problems, especially considering their empirical multivariate associations with high-risk drinking; accordingly, screening for problem gambling is recommended. More research is warranted to elucidate the etiologic mechanisms of these associations.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Factors
  • Alcohol Drinking / epidemiology*
  • Athletes / psychology*
  • Diagnostic and Statistical Manual of Mental Disorders*
  • Female
  • Gambling / diagnosis*
  • Gambling / epidemiology*
  • Health Surveys
  • Humans
  • Logistic Models
  • Male
  • Odds Ratio
  • Prevalence
  • Students / psychology
  • United States / epidemiology
  • Universities
  • Young Adult