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Disordered gambling among
  racial and ethnic groups


    CARLOS BLANCO, M.D., PH.D.
  COLUMBIA GAMBLING DISORDERS CLINIC,
  NEW YORK STATE PSYCHIATRIC INSTITUTE

      DEPARTMENT OF PSYCHIATRY,
         COLUMBIA UNIVERSITY
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
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

     No differences across racial/ethnic groups were found


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




      No differences across racial/ethnic groups were found
Note: Assessed only among pathological gamblers (N=195)
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

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2010 Conference - Gambling in Diverse Populations (Blanco)

  • 1. Disordered gambling among racial and ethnic groups CARLOS BLANCO, M.D., PH.D. COLUMBIA GAMBLING DISORDERS CLINIC, NEW YORK STATE PSYCHIATRIC INSTITUTE DEPARTMENT OF PSYCHIATRY, COLUMBIA UNIVERSITY
  • 2. 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
  • 3. CNS Spectrums March 2009; 14(3) :132-142
  • 4. 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
  • 6. 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
  • 7. 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)
  • 8. 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
  • 11. Prevalence and Conditional prevalence of Disordered gambling Significantly different from Non-Hispanic Whites
  • 12. Prevalence and Conditional prevalence of Pathological gambling Significantly different from Non-Hispanic Whites
  • 13. Sociodemographic characteristics Note: Only significant differences from non-Hispanic Whites are shown
  • 14. Psychopathology rates and disability Note: Only significant differences from non-Hispanic Whites are shown
  • 15. 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 No differences across racial/ethnic groups were found Note: Assessed only among pathological gamblers (N=195)
  • 16. Treatment seeking rates No differences across racial/ethnic groups were found Note: Assessed only among pathological gamblers (N=195)
  • 18. 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
  • 19. 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
  • 20. 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