Relationships Between Problem-Gambling Severity and Psychopathology as Moderated by Income

J Behav Addict. 2016 Sep;5(3):429-38. doi: 10.1556/2006.5.2016.045. Epub 2016 Jul 21.


Background and aims Problem and pathological gambling have been associated with elevated rates of both Axis-I and Axis-II psychiatric disorders. Although both problem gambling and psychiatric disorders have been reported as being more prevalent among lower income vs. middle/higher income groups, how income might moderate the relationship between problem-gambling severity and psychopathology is incompletely understood. To examine the associations between problem-gambling severity and psychopathology in lower income and middle/higher income groups. Methods Data from the first wave of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) (n = 43,093) were analyzed in adjusted logistic regression models to investigate the relationships between problem-gambling severity and psychiatric disorders within and across income groups. Results Greater problem-gambling severity was associated with increased odds of multiple psychiatric disorders for both lower income and middle/higher income groups. Income moderated the association between problem/pathological gambling and alcohol abuse/dependence, with a stronger association seen among middle/higher income respondents than among lower income respondents. Discussion and conclusions The findings that problem-gambling severity is related to psychopathology across income groups suggest a need for public health initiatives across social strata to reduce the impact that problem/pathological gambling may have in relation to psychopathology. Middle/higher income populations, perhaps owing to the availability of more "disposable income," may be at greater risk for co-occurring gambling and alcohol-use psychopathology and may benefit preferentially from interventions targeting both gambling and alcohol use.

Keywords: NESARC; income; problem gambling; psychiatric disorders; psychopathology.

MeSH terms

  • Adolescent
  • Adult
  • Alcohol-Related Disorders / complications
  • Alcohol-Related Disorders / epidemiology
  • Female
  • Gambling / complications
  • Gambling / epidemiology*
  • Gambling / psychology*
  • Humans
  • Income* / statistics & numerical data
  • Logistic Models
  • Male
  • Middle Aged
  • Odds Ratio
  • Psychiatric Status Rating Scales
  • Severity of Illness Index
  • United States / epidemiology
  • Young Adult