CARLOS BLANCO, M.D. , PH.D.

C O L U M B I A G A M B L I N G D I S O R D E R S C L I N I C , N E W Y O R K S T A T E P S Y C H I A T R I C I N S T I T U T E

D E P A R T M E N T O F P S Y C H I A T R Y , C O L U M B I A U N I V E R S I T Y

Disordered gambling among racial and ethnic groups

Acknowledgments

  NIH grants DA019606, DA023200, MH082773

  New York State Office of Alcohol and Substance

Abuse Services (OASAS)

  American Foundation for Suicide Prevention

  New York State Psychiatric Institute

CNS Spectrums March 2009; 14(3) :132-142

The present study…

  Is the first national study to focus on racial/ ethnic differences in gambling disorders

  Investigates the prevalence and conditional prevalence of gambling disorders

  Compares sociodemographic and clinical characteristics among disordered gamblers from racial/ethnic groups

METHODS

2001-2002 NESARC Sample

  Nationally representative sample of 43,093 individuals

  18+ years old   Residing in the continental US, district of Columbia,

Alaska and Hawaii   Non-institutionalized civilians   Face-to-face interviews

NESARC Assessment

  NIAAA Alcohol Use Disorder and Associated Disabilities Interview Schedule –DSM-IV version (AUADIS-IV)

  Symptom questions that operazionalized DSM-IV criteria for :   Nicotine dependence   Alcohol and drug abuse and dependence   Mood, anxiety and personality disorders

  Number of medical conditions, Number of stressful life events (SRRS) and Disability score (SF-12V2)

Disordered gambling in the NESARC

  All respondents who had gambled 5 or more times in at least 1 year of their life (N=11,153) were asked about the symptoms of DSM-IV pathological gambling

  Disordered gamblers: Individuals meeting at least 3 criteria for DSM-IV pathological gambling (PG)

  Gambling venues, course and treatment measures assessed only among pathological gamblers

Disordered Gambling (N=567)

RESULTS

Prevalence and Conditional prevalence of Disordered gambling

Significantly different from Non-Hispanic Whites

Prevalence and Conditional prevalence of Pathological gambling

Significantly different from Non-Hispanic Whites

Sociodemographic characteristics

Note: Only significant differences from non-Hispanic Whites are shown

Psychopathology rates and disability

Note: Only significant differences from non-Hispanic Whites are shown

No differences across racial/ethnic groups were found

PG criteria, course and venues of gambling preferred

  Mean number of DSM-IV PG criteria: 6.4   Mean age of PG onset: 31 years old   Mean age of PG remission: 37 years old   36.7% did not meet criteria for PG in the last year   71% are engaged in casino gambling and 53% in non-

casino gambling

Note: Assessed only among pathological gamblers (N=195)

Treatment seeking rates

Note: Assessed only among pathological gamblers (N=195)

No differences across racial/ethnic groups were found

LIMITATIONS & CONCLUSIONS

Limitations

  Assessment of pathological and disordered gambling were based on self-report

  NESARC does not provide information on adolescents

  Native Americans and Asians were combined into one group

  Analyses of gambling correlates were conducted only among pathological gamblers

Conclusions

  Prevalence of disordered gambling differs across racial/ethnic groups

  Blacks and Hispanics face increased socioeconomic adversity than non-Hispanic Whites

  Despite social adversity, Black and Hispanics are less likely to present substance use disorders.

  Similarities in symptom patterns, course and treatment seeking rates suggest no racial or cultural impact on the presentation of pathological gambling

Funding and Support

  NESARC was sponsored and conducted by NIAAA and supported by NIDA

  This research was also supported by NIH and AFSP grants and the NYSPI